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Issue Number - Name
0119-Transforaminal Epidural Steroid Injection to the Lumbar or Sacral Level
Review Type
Claim Type
Professional Services (Physician/Non-Physician Practitioner)
Region and State
JE, JF, JL and JH
Date Approved


Lumbar epidural injections are generally performed to treat pain arising from spinal nerve roots. These procedures may be performed via three distinct techniques, each of which involves introducing a needle into the epidural space by a different route of entry. These are termed the interlaminar, caudal, and transforaminal approaches. The procedures involve the injection of a solution containing local anesthetic with or without corticosteroids. In order to be considered medically necessary, they must meet certain indications and procedural requirements.

Affected Code(s)

64483, 64484

Applicable Policy References

L34980, Lumbar Epidural Injections (Noridian – JE, JF), Revision Effective DOS on or after 10/01/2017