Question regarding Lumbar Plexus nerve block

daniellef

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Wyomissing, PA
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Looking for some guidance to determine whether the use of unlisted code 64999 is appropriate for billing a lumbar plexus nerve block for post op pain management or if this would fall under CPT 64449 since the injection technique was given via catheter. Since the infusion lasted only 13 minutes wasn't sure if this qualified for billing under code 64449. Any help would be greatly appreciated:)

Anesthesia Block
Procedure: Nerve Block
Nerve Block Location: Other Lumbar plexus Laterality: Left Approach: Posterior

Did Surgeon Request a Block for this Case? Yes
Reason for Block: post-op pain management

Needles
Injection technique: Catheter

Needle type: Tuohy Gauge: 18 G Length: 4 in
Catheter at skin depth: 13 cm

Procedures
Guidance: nerve stimulator

Nerve Stimulator or Paresthesia
Motor response or paresthesia obtained: quad, 1.2 mA, 0.5 minimum mA

Narrative

Start time: 4/21/2022 11:02 AM
End time: 4/21/2022 11:15 AM
Injection made incrementally with aspirations every 3 mL.
Events: None
Bolus Medication: ROPivacaine (NAROPIN) 0.2% (2 mg/mL) - Perineural, 30 mg
 
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Hi there, I found an old CPT Assistant article that says to report lumbar plexus blocks with 64450. However, the payer has the final say.

Keep in mind that the use of a catheter alone doesn't dictate how you code.
 
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