Find Clarity on When to Use Unlisted Procedure Code
Question: When is it appropriate to report CPT® code 64450 versus 64999? Codify Subscriber Answer: First, let’s look at the code descriptors for these codes: The most important distinction is in the descriptor for 64450. Use this code for injections in any peripheral nerve or branch that does not have a more specific code. Two examples of blocks that you would code with 64450 instead of 64999 are intercostobrachial blocks and common peroneal nerve blocks. So, when would you bill 64999? If a provider injects into a fascial plane that does not have a specific code, 64999 would be appropriate. In recent years, CPT® has released new codes to describe some of these procedures, but there are still some procedures that may not have a more specific or suitable code. For example, you would code a quadratus lumborum block with 64999. When considering nerve block codes, documentation is also important to determine if you can bill the service. If the block was used as the main anesthetic, then you cannot bill it separately. The surgeon must request the block for postoperative pain, and not the main form of anesthesia, for you to bill it separately. Julie McDaniel, MHA, CPC, CANPC, Contributing Writer
