Neurology & Pain Management Coding Alert

Reader Question:

Combo Nerve Injections Aren't Unlisted

Question: Should I use 64999 (Unlisted procedure, nervous system) to report a nerve block injection that was a combination anesthetic and steroidal agent?
Kansas Subscriber

Answer: According to AMA's April 2005 CPT Assistant, the short answer is no. Choose an appropriate injection code from the -Somatic Nerves- (64400-64450) or -Sympathetic Nerves- (64505-64530) series.

Tip: -The inclusion of a steroidal agent does not alter the fundamental application of the nerve block injection codes (i.e., 64400-64450, 64505-64530),- CPT Assistant states. The primary purpose of the injection is covered with the nerve block injection codes as written. Adding a steroidal agent does not change the code selection.  For example, the addition of diluents or other agents does not change a code selection.

Also: Don't report additional codes for the injection of the steroid. This is covered in the primary code corre-sponding to the nerve block.