Eli's Rehab Report

Published on Sun Jan 01, 2006 PDF

Question: What is a psoas compartment block, and what code should I use for it?


Vermont Subscriber

Answer: A psoas compartment block is also another name for a lumbar plexus block. A physiatrist may perform this service by either a continuous catheter infusion or single injection. If your physiatrist's documentation indicates that the block was with a continuous catheter infusion, use should use 64449 (Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter [including catheter placement] including daily management for anesthetic agent administration).

Unfortunately, you won't find a CPT code for a single lumbar plexus injection. You might try appending modifier 52 (Reduced services) to 64449. Another option is to report 64999 (Unlisted procedure, nervous system).

FYI: Lumbar plexus blocks produce anesthesia of most of the lumbar nerve roots and some of the sacral nerve roots. The psoas compartment is a relatively large and well-defined compartment comprised mainly of the psoas major muscle. The lumber plexus originates from the first four lumbar spinal nerves that join within the psoas compartment. These nerves supply motor and sensory innervation to the pelvis and lower extremities.

Your physiatrist usually uses psoas compartment blocks for postoperative analgesia for surgeries involving the lower extremities. A physiatrist may also perform this service for patients on anticoagulation therapy when a neuraxial block is contraindicated.