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Anesthesia Coding Alert

Reader Questions:

64449 Is Best for Psoas Compartment Block

Published on Mon Feb 27, 2006

Question: How should I code a psoas compartment block?


Nevada Subscriber
Answer: Report a psoas compartment block with CPT 64449 (Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter [including catheter placement] including daily management for anesthetic agent administration). If the physician only administers the injection and does not perform follow-up management, append modifier 52 (Reduced services).

Some coders ask why you don't report 64520 (Injection, anesthetic agent; lumbar or thoracic [paravertebral sympathetic]) if the physician only performs the injection. Code 64520 is not appropriate because of the nerve anatomy. Nerve branches in the psoas major muscle form the lumbar plexus, which is different from the lumbar paravertebral sympathetic nerve represented by 64520.  Reader Questions and You Be the Coder were reviewed by Trish Bukaukas-Vollmer, CMM, CPC, owner of TB Consulting in Myrtle Beach, S.C. 
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