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Tip: Identify covered nerve block procedures

Ambulatory Surgery Reimbursement Update, June 24, 2008

Along with the other major changes Medicare has made to their reimbursement system for 2008, Medicare has added many nerve block procedures not previously covered to their list of covered procedures. Note that many of the nerve block procedures added reimburse at a low rate, so it might be best for your ASC’s bottom line if you perform these as add-on procedures to more extensive procedures reimbursing at a higher rate.

Consider the following nerve block procedures that Medicare now covers: 

  • Code 64400 for somatic nerve blocks of the face
  • Code 64402 for somatic nerve blocks of the muscles of facial expression
  • Code 64405 for somatic nerve blocks of the scalp
  • Code 64408 for a somatic nerve block of the vagus nerve
  • Code 64412 for somatic nerve blocks of the trapezius and lower neck
  • Code 64413 for a somatic nerve block at the C2–C4 level (lesser occipital, greater auricular, and supraclavicular nerves)
  • Code 64416 for interscalene somatic blocks (i.e., brachial plexus block) of the shoulders, chest, arms and hands performed with a catheter
  • Code 64418 for a somatic nerve block at the C5–C6 level
  • Code 64425 for an injection of an anesthetic agent in the ilioinguinal or iliohypogastric nerves
  • Code 64435 for somatic nerve blocks of the uterine nerve
  • Code 64445 for a single injection into the sciatic nerve
  • Code 64446 for an injection into the sciatic nerve by continuous catheter infusion
  • Code 64447 for a single injection into the femoral nerve
  • Code 64450 for an injection of an anesthetic agent into a peripheral nerve or branch not covered by the other nerve block codes.

This tip is brought to you by Ellis Medical Consulting, Inc.