Anesthesia Coding Alert
Lean Toward This Code for Post-op Bier Bock
Question: What is the appropriate CPT® code for a postoperative Bier block for pain management? Some sources say to use 64450 and others say 64449. Pennsylvania Subscriber Answer: If the physician administers the block for postoperative pain control, your best option is to report 64450 (Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch). However, if your provider administers a Bier block to treat complex regional pain syndrome (CRPS), your coding will differ. In that situation, report the block with 64999 (Unlisted procedure, nervous system) and include thorough documentation of the situation. Good to know: The anesthetic’s delivery during a Bier block sets it apart from other anesthesia techniques. The anesthesiologist normally injects the anesthetics around a nerve. With a Bier block (which is the most common type of intravenous regional anesthesia), he or she injects the anesthetic directly into the blood supply that feeds the nerves being treated. Bier blocks (otherwise known as perfusion blocks) are the only ones that involve administering the anesthetic intravenously rather than perineuronally.
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