Urology Coding Alert

Question: When the urologist does a nerve block to perform an injection procedure for Peyronie's disease, what code should I use for the nerve block?


North Carolina Subscriber

Answer: For the nerve block that the urologist performed, you should report 64450 (Injection, anesthetic agent; other peripheral nerve or branch).
 
For the procedure described, you would also report either 54200 (Injection procedure for Peyronie's disease) or 54205 (... with surgical exposure of plaque). Use diagnosis code 607.85 (Peyronie's disease).

Medicare will not reimburse for any anesthetic service administered by the operating surgeon or urologist. CPT, however, does not specifically mention regional nerve blocks in the definition of its "global surgical package." As a result, you may receive reimbursement for regional nerve blocks from some private carriers. Be sure to check with your carriers before submitting these codes.

Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook; and Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 31-urologist practice in Indianapolis.