# Celiac Plexus Block w/ Neulolysis



## baash1124 (May 22, 2009)

Can anyone help me with how to code this?

Thanks.

CT-GUIDED CELIAC BLOCK:

INDICATION: Advanced pancreatic cancer, intractable pain.

TECHNIQUE: After written informed consent was obtained under sterile
conditions with the patient placed in the right lateral decubitus
position via paraspinal posterolateral approach a 21-gauge spinal needle
was advanced to the left paraaortic space. Small amount of contrast was
injected. A test dose of 5 mL of 2% lidocaine was infused. Patient
reported some degree of mild pain relief with the injection. Next, a
total of 20 mL of absolute _______ was slowly infused for neurolysis of
the celiac plexus. Patient tolerated the procedure well. Post-procedure
scanning showed dispersion of the injected under the iodinated contrast
into a location at L1 at the expected location of the celiac plexus.

IMPRESSION: 

Celiac plexus block and neurolysis as described.


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## Shirleybala (May 24, 2009)

CT NERVE BLOCK CELIAC PLEXUS	77012
CT NERVE BLOCK CELIAC PLEXUS	64530

The physician injects the celiac plexus with an anesthetic to block sympathetically mediated or visceral pain. Anesthesia is provided with or without radiologic monitoring.

64680 – celiac plexus neurolysis  , 77012

The physician destroys the celiac plexus by applying a neurolytic agent to the celiac plexus. The celiac plexus is a network of nervous tissue that mediates sympathetic pain from the abdomen. This neurolytic block is often performed for pain relief of unresectable cancer in the upper abdomen. The celiac plexus is destroyed usually by chemodenervation, injecting phenol or alcohol to paralyze the network of nervous tissue. This procedure may be performed with or without radiologic monitoring, but is normally performed under CT guidance.

This is my suggestion I am not dealing with nerve block.


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## baash1124 (May 28, 2009)

Thanks for your help!

Bridget


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