# Anesthesia-Paravertebral blocks



## bballmom11 (Sep 17, 2010)

I will would like to see how others are billing the paravertral blocks.  Please see the attached description that our physician provided for us. 

The paravertebral blocks we use are more lateral to the spinal column thatn the facet blocks. In fact, we are blocking the nerves peripherally, an inch outside of the spine.  Multiple injections are employed to optimize spread of the local anesthetic solution to cover multiple dermatomes so a large surgical area can be covered, (as opposed to facet blocks that target individual nerve roots.

I welcome your feed back.


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## dwaldman (Sep 17, 2010)

What are you currently billing? And what is the main target of the injection?


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## bballmom11 (Sep 20, 2010)

Currently we are using 62310 and 64450 for additional areas.  As far as the target are, according to our physician it is to cover a large surgerical area.


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## dwaldman (Sep 21, 2010)

I still confused what is being done. You are injecting into the epdural space either caudal approach or interlaminar approach. Then they are injecting what? To bill 64450 you would have to be injecting a peripheral nerve that is not listed in 64400-644xx codes. If they are just blocking to side of the spine to cover "a larger area" then I think this would better be represented by 20552 then you would have to put the 59 on 62311 and determination of the 59 would have be determined appropriate. And you are running into the position of a commercial carrier using this code edit to deny your epidural.


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