ICD-10-CM Diagnosis Codes for Epidural Steroid Injections (CPT 64479–64484)

Epidural steroid injections (ESIs) are reported with CPT 64479–64484. Coverage under Medicare Local Coverage Determinations (LCDs) generally requires specific radiculopathic or stenotic diagnoses. (Legacy code 80053 is obsolete.)

Commonly Accepted Indications (Representative)

Typically Non-Covered / Unsupported

• Axial back pain without radiculopathy (M54.5).
• Non-specific myalgia, fibromyalgia (M79.7, M54.5).
• Peripheral neuropathy unrelated to spine (G60–G64).
• Headache/migraine (G43, G44).
• Vascular claudication (I73.9).

Documentation Requirements

• Correlative imaging (MRI/CT) showing compressive lesion at the injected level.
• Failed conservative care (PT, NSAIDs, activity modification ≥6 weeks).
• Radiculopathic symptoms matching the injected level.

Always verify the specific MAC LCD (Novitas, NGS, Palmetto, etc.) for exact covered codes, frequency limits, and documentation requirements.