Anesthesia Coding Alert

Question: If the anesthesiologist administered 64488 (bilateral, by injection) and also placed 64487 (by continuous infusion on the right side only) can both codes be billed together? If so, do we need to include a modifier?

Florida Subscriber

Answer: No, you cannot submit 64487 (Transversus abdominis plane [TAP] block [abdominal plane block, rectus sheath block] unilateral; by continuous infusion[s] [includes imaging guidance, when performed]) on the same claim as 64488 (Transversus abdominis plane [TAP] block [abdominal plane block, rectus sheath block] bilateral; by injections ([includes imaging guidance, when performed]).

Here’s why: Correct Coding Initiative (CCI) edits list 64487 as a Column 2 code with 64488 as the associated Column 1 code. That means the work of 64487 is included in the work of 64488; you only bill 64488. The edits do not allow you to append a modfier to “break” the edit pair and report both codes.