# Post op pain mgmt bier nerve block



## mkndevh@msn.com (Apr 22, 2019)

Does anyone know the CPT for a post OP pain mgmt Bier nerve block?  I'm getting some saying 64450 and others saying 64499? TIA


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## dwaldman (Apr 27, 2019)

Below is from AMA CPT Asisstant
AMA CPT Assistant November 2004
Reporting Bier Block Administration

Page 15 of the May 2004 CPT Assistant states that CPT code 01995, Regional intravenous administration of local anesthetic agent or other medication (upper or lower extremity), is the appropriate code to report for a Bretylium Bier Block by intravenous administration. Upon further review and comments received from our specialty advisor, a Bretylium Bier Block administered for complex regional pain syndrome (CRPS) should be reported with code 64999, Unlisted procedure, Nervous System. A Bier Block (IV regional block) is performed with local anesthetic and/or other agents (guanethidine, steroids, etc) introduced into a vein after a tourniquet is inflated. The medication then diffuses into the perineural tissues producing neural blockade and analgesia.

A point of further clarification, chronic reflex pain syndrome was indicated as CRPS but it should have read complex regional pain syndrome (CRPS).


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