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Coding and Modifier Guidance for Perioperative Peripheral Nerve Blocks

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The following article is written by Rosalind Richmond, chief coding and compliance officer for GENASCIS.


CPT copyright 2010 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

 

It is appropriate to report the codes (CPT codes 64400-64520) below in conjunction with an operative anesthesia service when a peripheral nerve block injection for post operative pain management is performed.

 

These injections are administered pre-, inter- or post- operatively.

 

CPT

DESCRIPTION

64415

Injection, anesthetic agent; brachial plexus, single

64416

Injection, anesthetic agent; brachial plexus, continuous infusion by catheter (including catheter placement)

64417

Injection, anesthetic agent; axillary nerve

64418

Injection, anesthetic agent; suprascapular nerve

64445

Injection, anesthetic agent; sciatic nerve, single

64446

Injection, anesthetic agent; sciatic nerve, continuous infusion by catheter (including catheter placement)

64447

Injection, anesthetic agent; femoral nerve, single

64448

Injection, anesthetic agent; femoral nerve, continuous infusion by catheter (including catheter placement)

64449

Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement)

64450

Injection, anesthetic agent; other peripheral nerve or branch

64520

Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)

 

The modifiers below are approved modifiers for use with peripheral block procedures. Payment will only be made once during an episode of care. Modifier -59 is required to distinguish the block from the intraoperative anesthetic technique. This is especially important when the same provider performs the nerve block and the intraoperative anesthesia.

 

Modifier

Description

-50

Bilateral Procedure

-59

Distinct Procedural Service

-73

Discontinued Out-Patient/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia

-74

Discontinued Out-Patient/Ambulatory Surgery Center (ASC) Procedure After the Administration of Anesthesia

-LT

Left side (used to identify procedures performed on the left side of the body)

-RT

Right side (used to identify procedures performed on the right side of the body)

 

Learn more about GENASCIS.


The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.

 

Read more from GENASCIS:

 

- Is Facility Fee Charge Waived for Medicare When Using Modifier -33

 

- 2011 Musculoskeletal Coding Update

 

- GENASCIS Announces Development of MEDIBIS Mobile

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