Neurosurgery Coding Alert

Question: Our pain management specialist administered a neurolytic celiac plexus block and bilateral splanchnic nerve block. What codes should we report?

Utah Subscriber

Answer: Submit 64680 (Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus) with one unit of service.

Explanation: Code 64680's descriptor simplifies your choice for the celiac plexus block. The celiac plexus is a network of ganglia and nerves, including the greater and lesser splanchnic, which is why 64680 also applies to that injection. Code 64680 represents destruction; the injection typically "floods or bathes" the plexus. If your provider performed bilateral splanchnic blocks during the same setting, he administered the first as an anesthetic for the destruction. The anesthetic injection would not be separately billable, which is why you report 64680 only once and without a modifier.