It was assumed that erector spinae is one example, but an FAQ in the January 2018 issue of the CPT® Assistant newsletter referred to code 64999 instead.
Patient had insertion of erector spinae plane block under IV sedation – regional nerve catheter under sedation. If the erector spinae plane block is inserted for pain management only do we still need to code it? Yes.
However, according to some physicians, the erector spinae is actually a paravertebral structure that is commonly addressed, injected, or treated, when performing postoperative pain blocks or managing postoperative pain.
The erector spinae plane blocks... are ultrasound-guided techniques for thoracoabdominal wall analgesia involving injection into the musculofascial plane between the paraspinal back muscles and underlying thoracic vertebrae. The ESP block targets the tips of the transverse processes. It is categorized as a paravertebral block.
Answer: There is no specific CPT code that describes this service; therefore, code 64999, Unlisted procedure, nervous system, should be reported for the ESP block.
9: Dorsalgia, unspecified.
M54. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M54. 9 became effective on October 1, 2021.
5 – Low Back Pain. ICD-Code M54. 5 is a billable ICD-10 code used for healthcare diagnosis reimbursement of chronic low back pain. Its corresponding ICD-9 code is 724.2.
The current code, M54. 5 (Low back pain), will be expanded into three more specific codes: M54. 50 (Low back pain, unspecified)
ICD-10 code Z98. 890 for Other specified postprocedural states is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
S39. 012, Low back strain.
6: Pain in thoracic spine.
For starters, dorsalgia is severe back pain, which could be coming from different parts of the spine. Depending on the specific section of the spine where the pain is coming from, there are six types of dorsalgia.
ICD-10-CM Code for Pain in thoracic spine M54. 6.
CoughICD-10 code R05 for Cough is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
17: Radiculopathy Lumbosacral region.
Patient had insertion of erector spinae plane block under IV sedation – regional nerve catheter under sedation. If the erector spinae plane block is inserted for pain management only do we still need to code it?
Yes. As per ACS 0042 Procedures normally not coded – classification point 2 ‘cerebral anaesthesia is required in order for the procedure to be performed’ a code from block [63] Administration of anaesthetic agent around other peripheral nerve should be assigned with IV sedation sequenced immediately following.
CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
This article contains coding and other guidelines that complement the Local Coverage Determination (LCD) for Pain Management. Coding Information: Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits.
The use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in the attached determination.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.