Advanced Search

Anesthesia Coding Alert

Reader Question:

Code Lumbar Sympathetic and Chain Blocks the Same

Published on Mon Nov 22, 2004

Question: How should I code a lumbar sympathetic chain block? What is the difference between this and a lumbar sympathetic block? One of our physicians administered both types of blocks (but on different patients).

New Mexico Subscriber Answer: Anatomically, the sympathetic nerves are a chain of nerves that run on the front side of the spinal vertebrae. Providers typically inject about 10cc per level injected, which is a much larger volume of medication than with epidural steroid injections (ESI) or facet injections. The increased volume allows the medication to spread up and down the sympathetic chain, producing an improved sympathetic block.

The terminology your physician used here is similar to the old saying "You say tomato, I say to-mah-to." Whether he calls it a lumbar sympathetic block or a lumbar sympathetic chain block, he still performs the same procedure. Report it with 64520 (Injection, anesthetic agent; lumbar or thoracic [paravertebral sympathetic]). - Answers to You Be the Coder and Reader Questions were provided by Catherine Brink, CMM, CPC, CMSCS, president of HealthCare Resource Management Inc., in Spring Lake, N.J.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Anesthesia Coding Alert

View All