Anesthesia Coding Alert

Question: How do I bill a single lumbar plexus injection instead of continuous infusion? 


West Virginia Subscriber


Answer: Many lumbar plexus blocks are continuous infusion, which you should report with CPT 64449 (Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter [including catheter placement] including daily management for anesthetic agent administration). But when the lumbar plexus block is not administered by continuous infusion, the coding gets trickier - CPT Codes does not include a code for a lumbar plexus injection.

Your best option is to still report 64449, but append modifier 52 (Reduced services) since it's a single injection instead of continuous infusion. Include documentation that explains the situation. Note: Most codes for single injections have zero global days and a reduced RVU valuation, but 64449 includes daily management and carries a 10-day global period. If the patient returns for another injection within 10 days, you cannot bill separately for it.