Neurosurgery Coding Alert
Leave Guidance Code off This CRPS Injection
Question: A patient who suffers from type 1 complex regional pain syndrome (CRPS) in their right arm reports to the surgeon for a nerve block. The surgeon injects the cervicothoracic ganglion to block pain in the patient’s right arm. The surgeon also used fluoroscopy during the injection. Can I report the fluoroscopy separately? AAPC Forum Subscriber Answer: No, you cannot report the fluoroscopy separately; it is bundled into the codes for these nerve injections. On the claim, report 64510 (Injection, anesthetic agent; stellate ganglion (cervical sympathetic)) for the block with modifier RT (Right side) appended to indicate laterality. Don’t forget: Append G90.511 (Complex regional pain syndrome I of right upper limb) to 64510 to represent the patient’s CRPS.
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