Anesthesia Coding Alert

Question: What is a TAP catheter, and what’s the correct 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 his anesthesia during an abdominal laparoscopic procedure. As there is not a specific code to report a TAP catheter, report with 64999 (Unlisted procedure, nervous system) and submit a copy of the procedure report. It is also helpful to ask the provider for a similar procedure to provide a comparison for value to the insurance company.

Before coding, 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 separately.

In contrast to the catheter, which is reported with an unlisted code, a single TAP block nerve injection may be reported using several different codes, depending on the location of the injection. If the TAP block is in the ilioinguinal or iliohypogastric nerve, report code 64425 (Injection, anesthetic agent; ilioinguinal, iliohypogastric nerves).  If the TAP block is in the subcostal area (intercostal nerve), report 64421 (Injection, anesthetic agent; intercostal nerves, multiple, regional block).  Finally, if the TAP block is posterior, it is reported with 64450 (Injection, anesthetic agent; other peripheral nerve or branch), which covers “other peripheral nerve or branches” that are not listed separately.