Neurosurgery Coding Alert

You Be the Coder:

Bring In New PVB Codes in 2016

Question: Our physician performed a thoracic paravertebral block in a patient with spinal injuries. How can we report this procedure? Is it correct to submit codes 64470-64484 and 64490-64493?

Alabama Subscriber

Answer: According to current CPT® instructions, you should report these paravertebral injections (not facet joint injections) with one of the intercostal injection codes. The best codes are either 64420 (Injection, anesthetic agent; intercostal nerve, single) or 64421 (…intercostal nerves, multiple, regional block), depending upon how many nerves your physician injects.

However, in a few weeks from now in the New Year, you will find specific codes for this procedure. The new 2016 codes are the following:

  • 64461 – Paravertebral block (PVB) (paravertebral block), thoracic; single injection site (includes imaging guidance, when performed)
  • +64462 – … second and any additional injection site(s) (includes imaging guidance, when performed) (List separately in addition to code for primary procedure)
  • 64463 – … continuous infusion by catheter (includes imaging guidance, when performed).