Pain Management Coding Alert

You Be the Coder:

How to Report Needle Guidance With Nerve Block

Question: Our provider used both ultrasound guidance and electrical stimulation for needle guidance for a peripheral nerve block.  What would be the proper coding for this? 

California Subscriber 

Answer: Use of a nerve stimulator to locate the peripheral nerve is not separately billable. The CCI Edits Manual states, “Electrical stimulation used to identify or locate nerves during a procedure involving treatment of a cranial or peripheral nerve (e.g., nerve block, nerve destruction, neuroplasty, transection, excision, repair) is integral to the procedure and is not separately reportable.” The use of the nerve stimulator is inclusive to the nerve block, but if the CPT® documentation requirements have been met, you can code the ultrasound guidance with 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation).