# Xiphoid injection/block



## viksash (Apr 5, 2010)

My doctor doing a xiphoid injection/block, can any one let me know which cpt code I should use?

Thank you 
Viktoriya Fotiyev, CPC


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## rkmcoder (Apr 5, 2010)

(These are my opinions and should not be construed as being the final authority.  Other opinions may vary.)

If your doc is injecting the joint between the xiphoid process (XP) and rib, then look at 20600 (some will say 20605).  If your doc is injecting an intercostal nerve in the vicinity of the XP, then look at 64420.  Give us more info...

Richard Mann, your pain management coder
rkmcoder@yahoo.com


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## dwaldman (Apr 5, 2010)

https://www.aapc.com/memberarea/forums/archive/index.php?t-15456.html

In the above link, there is a post suggesting 20605 and they also suggest talking to the physician to confirm the code. The question or confirmation, I assuming is 20605 versus 20600, intermiadiate verus small joint size.


http://en.wikipedia.org/wiki/Xiphoid_process

The xiphoid process, also known as the xiphisternum or metasternum, is a small cartilaginous extension to the lower part of the sternum which is usually ossified in the adult human. By age 15 to 29, the xiphoid usually fuses to the body of the sternum with a fibrous joint. Unlike the synovial articulation of major joints, this is non-movable. Much the way the first seven ribs articulate with the sternum, the cartilage in the celiac plexus joins on the xiphoid process, reinforcing it, and indirectly attaches the costal cartilage to the sternum. In newborn babies and young (especially slender) infants, the tip of the xiphoid process may be both seen and felt as a lump just below the sternal notch.
Pressure on the xiphoid process should be avoided when administering chest compressions in CPR, as this can cause the xiphoid process to break off and be driven into the heart lining and muscle, resulting in punctures or lacerations of the diaphragm. The xiphoid process is considered to be at the level of the 9th thoracic vertebrae and the T7 dermatome.


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## viksash (Apr 5, 2010)

Thank you very much


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