Neurology & Pain Management Coding Alert

Question: What is a TAP catheter, and how do you report it on a claim?

Hawaii Subscriber

Answer: Providers sometime use a transverses abdominis plane (TAP) catheter as an alternative to epidural analgesia after upper abdominal surgery.

Before coding for a TAP block, you will need to know whether the catheter was placed unilaterally (one side) or bilaterally (two sides), and whether the administration was by continuous infusion or a single-shot injection.

The coding options for a TAP catheter (as in your scenario) 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 infusions (includes imaging guidance, when performed))

If the provider administers the TAP block by injection, choose between these two codes:

• 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 injections (includes imaging guidance, when performed))

Notice that all four codes include imaging guidance, so you won’t report an additional unit for imaging (when applicable).

Final tip: 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 it separately.