CPT^® 64421, Under Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Somatic Nerves

The Current Procedural Terminology (CPT^®) code 64421 as maintained by American Medical Association, is a medical procedural code under the range - Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Somatic Nerves.

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Summary

The provider injects an anesthetic agent and/or steroid close to one of the ventral branches of the thoracic spinal nerves located under each rib, called the intercostal nerve. Report this code for one or more injections of each additional level (second, third, fourth intercostal nerve, and so on) after the first level.

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Billing Intercostal NB 64420 & 64421

64420 is the primary code and 64421 is an add on code for each additional level beyond the first level represented by 64420 so modifier 59 would not be appropriate on either code. (Per Codify there ar... [ Read More ]

help with 64420, 64421

HI Physican billed 64420 and 64421*3. He says he treated 4 nerves from T3-T9. However , he did not document the name of the nerves or the levels in his procedure. He just mentioned he injected need... [ Read More ]

64420/64421 multiple injections

Hello, has anyone been successful in getting reimbursed when billing more than 3 levels to Blue Cross? For example I have a case where Bilateral T1-T8 Intercostal nerves(so 7 levels?) were injected. I... [ Read More ]

Two intercostal nerve block of the left anterior thorax

On this procedure, the 5th and 6th costochondral joint areas are injected. On 64420, it states it is an intercostal nerve, single level. Would the 5th and 6th costochondral joint area be a single le... [ Read More ]

Intercostal Brachial Nerve Block

64420 for single and 64421 for multiple.... [ Read More ]

flouroscopic guidance denial

u[QUOTE="kimmcelderry@gmail.com, post: 474118, member: 605208"] Hi there, I am not very familiar with billing in pain management procedures and we received a denial I am unsure about. We billed in thi... [ Read More ]

flouroscopic guidance denial

I believe you would also bill 77002 with 64420 and 64421 X3 . It is included within the "64400-64448" code set in the below note . (Use [URL='https://coder.aapc.com/cpt-codes/77002'][U]77002[/U][/... [ Read More ]

flouroscopic guidance denial

Yes, agree with the above. I see that 64421 was revised in 2020 to make it an add-on code now, so the Coders' Desk Reference guidance I cited in my last post is now out of date.... [ Read More ]

flouroscopic guidance denial

64420 is for a single level;[B] Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level[/B] and 64421 is and add on code to 64420; [B]Injection(s), anesthetic agent(s) and/o... [ Read More ]

Multiple intercostal nerve blocks

Hope you don't mind me jumping on this thread. Has anyone coded a cryoablation of intercostal nerves? My surgeon did a VATS with cryoablation & intercostal nerve block. Lung was dissected from the ... [ Read More ]

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