Anesthesia Coding Alert

Question: The CRNA administered a brachial plexus block. He wants to bill this with eight units but CPT^® says to report 64415 once per nerve plexus regardless of the number of injections performed along the nerve plexus. I’ve found conflicting advice when looking for help. What is the correct number on units that should be billed with 64415?

Nebraska Subscriber

Answer: You are correct in reporting 64415 (Injection(s), anesthetic agent(s) and/or steroid; brachial plexus) for a brachial plexus block. You also are correct in how to calculate the number of injections to report. According to CPT^® guidelines, “These codes are reported once per nerve plexus, nerve, or branch as described in the descriptor regardless of the number of injections performed along the nerve plexus, nerve, or branch described by the code.” Check the CRNA’s documentation to verify how many injections were made to each nerve or branch – not how many were administered in total – then code accordingly. Your CRNA may be confusing a previous year’s relative value unit (RVU) of 8, although these values were replaced in the 2020 American Society of Anesthesiologists (ASA) Relative Value Guide^®(RVG). The 2021 RVG^® lists a work RVU of 1.35, although the number of units to report will remain at one.