Wiki Erector Spinae Plane Block

[CandaceLucio]

Hi there-
Does anyone know what CPT code should be used for a Erector Spinae Plane Block ? Everything I have found says to use the unlisted 64999. If anyone has any supporting documentation on this topic and would like to share that would be great. Thank you in advance.

 

[jkyles]

Hi there, CPT Assistant 1/2018 and 12/2018 both state the block is billed with the unlisted code. For example:

"There is no specific CPT code that describes this service; therefore, code 64999, Unlisted procedure, nervous system, should be reported for the ESP block."

And

"...the erector spinae is a group of muscles and tendons extending the length, and on both sides, of the spine. It is not a separately identified spinal nerve or branch."

 

[CandaceLucio]

Thank you. I wanted to make sure I wasn't missing something.

 

[Bramoscenter]

I have a question. Can you bill 64461 for Erector Spinae Nerve Block instead of 64999. I am having trouble getting 64999 paid.

 

[LisaAlonso23]

I have a question. Can you bill 64461 for Erector Spinae Nerve Block instead of 64999. I am having trouble getting 64999 paid.

Per CPT assistant, you need to bill 64999 for the Erector Spinae block. I suggest appealing with the block notes if the block was performed by the anesthesiologist. If the surgeon performed the block, in addition to a surgical procedure, it's not separately billable.

 

[jkyles]

I have a question. Can you bill 64461 for Erector Spinae Nerve Block instead of 64999. I am having trouble getting 64999 paid.

Check the payer policy. Most payers don't cover ESP blocks. But you can not ever report a different code for a service because the appropriate code isn't being paid.

 

[vanmarin]

Per CPT assistant, you need to bill 64999 for the Erector Spinae block. I suggest appealing with the block notes if the block was performed by the anesthesiologist. If the surgeon performed the block, in addition to a surgical procedure, it's not separately billable.

HI, do you have documentation stating surgeon cannot bill separately for the surgical procedure, im trying to locate information for my provider. Thank you

 

[LisaAlonso23]

HI, do you have documentation stating surgeon cannot bill separately for the surgical procedure, im trying to locate information for my provider. Thank you

Per NCCI manual, Chapter 2:
Per Medicare Global Surgery rules, the physician performing an operative procedure is responsible for treating postoperative pain. Treatment of postoperative pain by the operating physician is not separately reportable.

 

[vanmarin]

Per NCCI manual, Chapter 2:
Per Medicare Global Surgery rules, the physician performing an operative procedure is responsible for treating postoperative pain. Treatment of postoperative pain by the operating physician is not separately reportable.

thank you very much for this information