Anesthesia Coding Alert

Question: Which code is used for a bier block/ sympathetic block with bretylium?

Minnesota Subscriber

Answer: First, check with your local carrier to ensure that the block is a covered service. Some coders have success with 64450* (Injection, anesthetic agent; other peripheral nerve or branch), but this code isn't necessarily the best option because it deals with peripheral nerves, and the rectus abdominus muscle you're injecting is not peripheral.

A better option is to use 64999 (Unlisted procedure, nervous system) since no CPT code is specific for the procedure, and submit the claim with supporting documentation. As coders we try to use the most specific codes possible and don't like to use unlisted-procedure codes because they are vague, but it's often the only alternative when other codes don't fully describe the procedure performed.