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Anesthesia Coding Alert

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Technique Determines Impar Block Code

Published on Thu May 13, 2004

Question: What is a ganglion or impar block, and how should I code for it?

Mississippi Subscriber
 
Answer: If the physician performs a neurolytic (destructive) block, report CPT 64640 (Destruction by neurolytic agent; other peripheral nerve or branch). Otherwise, report the unlisted-procedure code 64999 (Unlisted procedure, nervous system) at 12 units.

Pain physicians perform ganglion impar or ganglion of Walther blocks to treat sympathetically mediated pain of the perineum, rectum and genitalia. The pain is usually secondary to malignancy or a benign pain syndrome such as endometriosis, reflex sympathetic dystrophy or causalgia.
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