Anesthesia Coding Alert

Question: What is a TAP catheter, and what’s the correct way to code for it?

Mississippi Subscriber

Answer: Providers sometime use transverses abdominis plane (TAP) catheters as an alternative to epidural analgesia after upper abdominal surgery. An anesthe­siologist might also use a TAP catheter as an adjunct to their anesthesia during an abdominal laparo­scopic procedure. Although TAP catheters have been reported as unlisted procedure codes in the past, in 2015 new codes were added to describe the service laterality and either with or without imaging guidance.

If the TAP block is placed for continuous infusion, your code options are:

• 64487 (Transversus abdominis plane (TAP) BLOCK (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s)— includes imaging guidance, when performed)
• 64489 (Transversus abdominis plane (TAP) BLOCK (abdominal plane block, rectus sheath block) bilateral; by continuous infusion(s)— includes imaging guidance, when performed)

A single TAP block nerve injection may also be reported using several different codes, also depending on the laterality and imaging guidance. That single-injection block is coded with:

• 64486 (Transversus abdominis plane (TAP) BLOCK (abdominal plane block, rectus sheath block) unilateral; by injection(s)—includes imaging guidance, when performed)
• 64488 (Transversus abdominis plane (TAP) BLOCK (abdominal plane block, rectus sheath block) bilateral; by injection(s)—includes imaging guidance, when performed)

Tip: Before submitting any of these codes, determine whether your provider inserted the TAP catheter for postoperative pain management or if the physician used the block as part of anesthesia during the surgery. If the catheter was used during the surgery as an adjunct to the anesthesia, you shouldn’t report the block separately.

Bonus tip: As all of the TAP codes include imaging guidance, do not report imaging separately.