Neurology & Pain Management Coding Alert

Question: What is a psoas compartment block, and what code should I use for it?


Tennessee Subscriber

Answer: A psoas compartment block is another name for a lumbar plexus block. Your neurologist may perform this service by a continuous catheter infusion or single injection.

If the documentation indicates that the block was with a continuous catheter infusion, you should use 64449 (Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter [including catheter placement] including daily management for anesthetic agent administration).

Unfortunately, you won't find a CPT code for a single lumbar plexus injection. You might try appending modifier 52 (Reduced services) to 64449. Another option is to report 64999 (Unlisted procedure, nervous system).

FYI: Lumbar plexus blocks produce anesthesia of most of the lumbar nerve roots and some of the sacral nerve roots. The psoas compartment is a relatively large and well-defined compartment comprised mainly of the psoas major muscle. The lumbar plexus originates from the first four lumbar spinal nerves that join within the psoas compartment. These nerves supply motor and sensory innervation to the pelvis and lower extremities.

Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J; and Marvel Hammer, RN, CPC, CHCO, owner of MJH Consulting, a reimbursement consulting firm in Denver.