Pain Management Coding Alert
Continuous TAP Block Leads You to 'Unlisted' Code
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Question: Our physician used a TAP (Transverses Abdominis Plane) block for postoperative pain relief after anterior lumbar interbody fusion. I know that you would use 64450 when the physician doesn’t insert a catheter. Is 64449 the correct code to use for this block with a catheter?
Delaware Subscriber
Answer: No, 64449 (Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter [including catheter placement]) is not your most accurate choice. If you’re reporting continuous infusion rather than a single shot with catheter, report 64999 (Unlisted procedure, nervous system) since CPT® does not include a specific code for continuous infusion for other peripheral nerves. The CPT® Instructions for Use of CPT® Codebook directs providers, “Do not select a CPT® code that merely approximates the service provided. If no such specific service exists, then report the service using the appropriate unlisted procedure or service code.
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