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).
