Pain Management Coding Alert
Turn to 'Unlisted' for Sphenopalatine Lidocaine Administration
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Question: Our pain management specialist is looking into administering Lidocaine through a SphenoCath® to treat headaches. One person suggested that I code it as 64505. However, it appears that the Lidocaine is pushed through the catheter and absorbed through the mucous membrane, which to me is not an injection. How should I code this?
Massachusetts Subscriber
Answer: There is no specific CPT® code that accurately describes in injection of the sphenopalatine ganglion. The code set includes 64505 (Injection, anesthetic agent; sphenopalatine ganglion), which CPT® Assistant states is inappropriate for the procedure you describe. Therefore, your best option is the unlisted code 64999 (Unlisted procedure, nervous system).
Remember: When reporting an unlisted code to describe a procedure or service, you might need to include supporting documentation such as the procedure report with the claim to provide an adequate description of the nature, extent, and the need for the procedure, as well as and the time, effort, and equipment necessary to provide the service.
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Question: Our pain management specialist is looking into administering Lidocaine through a SphenoCath® to treat headaches. [...]