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#Ipack block cpt code

Providing this information to your coding and billing partner will help ensure proper payment.Ĭomplicating the ever-evolving billing and coding scenario is the fact that many of the relatively new nerve block approaches have yet to be recognized and included in the CPT code list.

Confirmation that the block was performed at the request of the surgeon.

Confirmation that the block was performed for postoperative pain management.

When the block was performed: before or after induction.

Please note that three main pieces of information are needed to bill a nerve block for postoperative pain management: This creates an ongoing challenge for billing and coding professionals to ensure that billing and coding not only accurately reflect surgical complexity and anesthesia time, but also capture the appropriate CPT code(s) for the acute pain management service or services provided. However, payment for nerve blocks (often performed with ultrasonic guidance) is made according to the Current Procedural Terminology (CPT ®) Fee Schedule in a manner similar to most other medical procedures. A uniqueness of anesthesia billing is that most anesthesia charges are calculated based on the difficulty of the surgical procedure and the amount of time required to manage the anesthetic. Steady innovation within the specialty has yielded many new safe and effective nerve block approaches and modalities, including the quadratus lumborum and IPACK blocks (see below).Īs new nerve block techniques and approaches emerge, coding and billing for acute pain management services evolve as well. Most anesthesia practices have found that nerve blocks for acute pain management provide a valuable opportunity to improve postsurgical outcomes, enhance the quality and safety of care, and increase patient satisfaction. While this innovation benefits patients, it also creates billing and coding challenges and underscores the importance of having a billing partner that understands this area and stays current with changes in the CPT® Codebook. New approaches and techniques are emerging all the time. Therefore, it would be appropriate to report CPT code 64493, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapohphyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral, single level, for the L5 medial branch block.įor the 4 lateral branch block injections at S1, S2, S3, and S4, report 4 units of CPT code 64450, Injection, anesthetic agent other peripheral nerve or branch.The growing use of nerve blocks for acute pain management is helping anesthesiologists improve the quality and safety of patient care.

based on the operative report a medial branch nerve block was performed at the L5 and a lateral branch nerve block was performed at the S1, S2, S3 and S4 What are the correct codes for a lateral nerve block?" "A patient was seen at our facility and underwent a left-sided L5 and S1, S2, S3, and S4 lateral branch nerve block for diagnostic purpose with C-arm fluoroscopy. Report multiple units of the injection for the four lateral branch block injections performed, modifier 59 would not be appended in this case. Therefore, for the four lateral branch block injections at S1, S2, S3, and S4, report 4 units of CPT code 64450, Injection, anesthetic agent other peripheral nerve or branch. The lateral branches of the dorsal sacral nerve plexus are considered peripheral nerves.

Are we correct in reporting lateral branch nerve block(s) to the peripheral nerve CPT code?" Yes, you are correct. Our Pain Center wants to use facet injection for the medial branch block and other peripheral nerve for the lateral branch block. "We are getting conflicting information regarding coding medial and lateral branch blocks S1, S2, and S3, Medial 64493, 64494, Lateral 64493, and 64494. The right CPT code 64450, Injection, anesthetic agent other peripheral nerve or branch, would be appropriately reported only once in this case since all 3 nerve blocks were administered to the same nerve or branch. "What are the appropriate code assignments when a patient receives 3 separate nerve blocks into the same lateral branch nerve? Would it be appropriate to report 3 units of this service?" Let's Review at the following Reader's Questions again: Please note: CPT code 64450 should only be reported per nerve or branch and not per injection.ĬPT code 76942, Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation, would be additionally reported when utilizing ultrasound guidance for certain nerve block procedures when it is not inherent in the primary procedure code. Looking at the lateral branch nerve is a peripheral nerve and would be reported with CPT code 64450, Injection, anesthetic agent other peripheral nerve or branch, when a lateral branch nerve block is performed.