AAPC - Back to school
Results 1 to 6 of 6

Thread: Intercostal Nerve Blcok

  1. #1
    Join Date
    Apr 2007

    Default Intercostal Nerve Blcok

    AAPC: Back to School
    If the doctor did the T5-6 intercostal nerve block would I bill 64421 once or would i bill 64421 twice

  2. #2


    Code 64420 once for a single stick. Code 64421 once for multiple sticks.

    Richard Mann, your pain management coder

  3. #3
    Join Date
    Apr 2007
    International Member


    I think once.

    Be'coz, 64421 says... intercostal nerves, multiple, regional block.

    And you are mentioned T5-6. (two. so not 64420).

  4. #4
    Join Date
    Apr 2007


    "The physician anesthetizes the intercostal nerve to block chest wall pain. In 64420, a single injection is performed. In 64421, multiple nerves are injected to provide pain relief to a larger area (regional block)."

    From Encoder, this description I feel helps clarfiy that 64421 is only billed once for mulitple nerves.

  5. #5
    Join Date
    Apr 2007
    Denver Colorado


    In a T5-T6 intercostal nerve block, the physician is blocking only a single intercostal nerve, T5, that is in the T5 & T6 interspace aka between the fifth and sixth thoraic ribs. So if the documentation is a dash, then it would be a single injection or 64420.

    If the physician performed T5 and a T6 intercostal nerve blocks, he would be blocking not only the T5 intercostal nerve located as above between the T5 & T6 interspace but also a second injection to block the T6 intercostal nerve in the T6 & T7 interspace aka between the sixth & seventh thoracic ribs. Since more than 1 intercostal nerve injection was performed, this would be a multiple block or 64421.

    The key is - Is the physician describing the needle placement location: T5-T6 or the specific intercostal nerves blocked: T5, T6. Something as simple as a dash or comma can change the coding - that is why it is important that we can't code from a procedure title but also need to verify the procedures in the procedure documentation detail section and/or confirm with the physician.

  6. #6
    Join Date
    Apr 2007


    Thanks for explaining this I totally missed that point when I responsed.

Similar Threads

  1. Intercostal nerve block
    By SJMarra in forum Neurology/Neurosurgery
    Replies: 1
    Last Post: 04-24-2014, 01:48 PM
  2. Multiple intercostal nerve blocks
    By b10sliger in forum Anesthesia
    Replies: 4
    Last Post: 06-17-2011, 11:22 PM
  3. Intercostal Nerve Destruction??
    By fuga in forum Anesthesia
    Replies: 2
    Last Post: 12-08-2009, 11:26 AM
  4. Intercostal Nerve Nuerolysis R T9-T12
    By LORIN830 in forum Anesthesia
    Replies: 1
    Last Post: 03-23-2009, 06:25 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.