Anesthesia Coding Alert

Question: How should I code a therapeutic nerve block of the femoral nerve when our pain management specialist uses a catheter for continuous infusion forthe block?

Texas Subscriber

Answer: Use 64448 (Injection, anesthetic agent; femoral nerve, continuous infusion by catheter [including catheter placement]) for the procedure described.

Your specialist might perform nerve blocks for either diagnostic or therapeutic purposes, but the reason for the block does not affect how you code. Pay attention to how the physician administers the nerve block (such as continuous infusion or single injection) to determine the correct code.

CPT^® lists each of the continuous infusion nerve block codes within the anesthetic agent injection, somatic nerve category, immediately following the code that describes a single injection block of the same nerve.

Example:  CPT^® lists 64448 directly beneath 64447 (... femoral nerve, single).

Bonus tip: A continuous nerve infusion by catheter means you have a 10-day global fee (with the exception of an epidural continuous infusion).

The code description clearly states "...including daily management for anesthetic administration." This is not true with a single injection, which is why 64447 carries 3.46 non-facility relative value units (RVUs), while 64448 is valued at 2.05.