# help coding CT guided glossopharyngeal block



## PEH350 (Nov 15, 2010)

How would you code the following procedure?

...patient was placed in the supine position. Imaging line was visualized on the Rt side from the mastoid process to the angle of the mandible and the styloid process.  The skin was prepped and using a 22-guage 1.5 inch needle, local % lidocaine was injected into the rt side of the face.  Once visualized  on the CT scanner, the appropirate landmarks were identified and advancement was placed at midpoint location in a perpendicular plain to the skin.  The styloid process was seen the needle was withdrawn and advanced just beyond the styloid process  posteriorly.   Careful aspiration revealed no blood or CSF.  Approximately 5 ml of 0.125% bupivacaine, as well as 40 mg of Depo Medrol was injected.

Would you code this as a 64450 peripheral nerve block?  64402 facial nerve block?  My doc's are in disagreement on this because of the locationa & CT use.  Any direction would be greatly appreciated.


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## dwaldman (Nov 15, 2010)

What is the physician state it should be. I had looked at the anatomy of the face a long time trying to fiqure out which code would best describe it in the past when there was question similiar to this.  And what is he in disagrement due to the CT guidance, how is that effecting his point of view? Again the physician who performed it can state if he felt that this injection would have therupeutic effect on the facial nerve and/or that was the intent or if other peripheral has to be used because it did not.


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## PEH350 (Nov 17, 2010)

David, 

Thank you very much.  The code for facial nerve will discribe the procedure the physicians are looking for much better than peripheral nerve block.


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