Anesthesia Coding Alert

Question: The anesthesiologist performed a nerve block procedure and the surgical procedure on a patient during the same day. She administered anesthesia during the patient’s arthroscopy with meniscus repair. She also administered a single femoral block at the adductor canal and an iPACK block. How do I code each of these services?

North Dakota Subscriber

Answer: The surgical code for the meniscus repair is 29882 (Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)), which crosses to anesthesia code 01400 (Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified).

Provided you have supporting documentation to report the femoral block separately, report it with 64450 (Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch).

The iPACK block is a technique that consists of administering a local anesthetic into the interspace between the popliteal artery and the capsule of the posterior knee. The procedure is meant to be used as an alternative analgesic supplement to the femoral or adductor canal blocks to alleviate posterior knee pain. The current edition of CPT^® does not have a code specifically for an iPACK block. Your only option is to submit 64999 (Unlisted procedure, nervous system) with documentation explaining the service.