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Anesthesia Coding Alert

Reader Question:

Report 64450 for Pain Relief Bier Block

Published on Thu May 13, 2004

Question: How should I code a Bier block for lidocaine infusion for pain relief (rather than anesthesia)? I've tried several codes but am unsure about the best one to report.

Nebraska Subscriber
 
Answer: Some coders report 90780 (Intravenous infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; up to one hour) and +90781 (... each additional hour, up to eight [8] hours [list separately in addition to code for primary procedure]) for these injections.

Your better option, however, is 64450 (Injection, anesthetic agent; other peripheral nerve or branch) because it better represents the procedure. But because 64450 is for an injection and your physician performed an infusion, also append modifier -22 (Unusual procedural services) and send notes explaining the procedure. Your final option is 64999 (Unlisted procedure, nervous system).
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