Neurology & Pain Management Coding Alert

Question: My physician documented that he placed a thoracic paravertebral block for post-op pain management. The only codes I’m finding for paravertebral blocks are 64470-64484 and 64490-64493, but I’m not sure if they apply for post-op pain management. Am I missing codes somewhere?

Alabama Subscriber

Answer: Currently, CPT^® instructs you to report these paravertebral injections (not facet joint injections) with one of the intercostal injection codes. Report either 64420 (Injection, anesthetic agent; intercostal nerve, single) or 64421 (…intercostal nerves, multiple, regional block), depending upon how many nerves your physician injects.

That will change in a few weeks, when 2016 will bring specific codes for this type of procedure:

• 64461 – Paravertebral block (PVB) (paravertebral block), thoracic; single injection site (including imaging guidance, when performed)
• + 64462 – … second and any additional injection site(s) (includes imaging guidance, when performed)(List separately in addition to code for primary procedure)
• 64463 – … continuous infusion by catheter (includes imaging guidance, when performed).