Gina Posted Tue 17th of March, 2020 11:32:23 AM
Is there a cpt code for Erector Spinae Plane nerve block? Would it be appropriate to bill the unlisted code 64999 and if so, what cpt code would be a comparable RVU?
Gina Posted Tue 17th of March, 2020 11:52:21 AM
I should add, the details include: The patient was placed in a prone position. The skin was prepped with chlorhexidine and sterile drapes were applied. The transducer was prepped with chlorhexidine, sterile contrast medium was applied and covered with a sterile sleeve. Sterile contrast gel was applied to the patients skin at the injection site. The transducer was placed over the target sites and the T12/L1 ribs and transver..
SuperCoder Answered Wed 18th of March, 2020 10:34:36 AM
Thanks for your question.
There is no specific CPT code for Erector Spinae plane (ESP) block; therefore, code 64999, unlisted procedure, nervous system should be used.
CPT® guidelines instruct that you should not choose a code that merely approximates the service provided. You should report the service using only the appropriate unlisted procedure code if no such specific procedure or service code exists.
You must report a Category III code when available in place of an unlisted procedure code.
When reporting a procedure with an unlisted code, submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. Include one or more similar codes, and compare your service to those codes to justify the claim amount you are billing. Also include the operative notes or other relevant documentation to strengthen the claim and to avoid a possible denial. Your payers will consider claims with unlisted procedure codes on a case by case basis, and they will determine payment based on the documentation you provide.
Hope this helps.