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paraspinous catheter for post-op pain management

Lynn Posted Tue 25th of October, 2016 07:19:58 AM
What code would be used for paraspinous catheter placement for post-op pain management, my doctor is wanting to use 32551--I don't think this is correct but not sure what to tell him to use. Thank you Anesthesia was unable to place an epidural preoperatively. A posterior pleural flap was raised, and a paraspinous catheter was inserted percutaneously and secured to the skin. The pleural flap was then reapproximated to the chest wall.  
SuperCoder Answered Wed 26th of October, 2016 04:32:09 AM

Greetings from!


Code 32551 is for thoracostomy and should be reported for respiratory procedures when a plastic tube is inserted into the chest cavity to remove fluids or air from the chest cavity. But insertion of catheter for pain management is different. CPT® introduced three new codes in 2016 for paravertebral/paraspinous nerve blocks for post-op pain management. These were:


  • 64461 - Paravertebral block (PVB) (paraspinous block) thoracic; single injection site (includes imaging guidance, when performed)


  • + 64462 - second and any additional injection site(s) (includes imaging guidance, when performed)(list separately in addition to code for primary procedure)


  • 64463 - continuous infusion by catheter (includes imaging guidance, when performed)


To report the performance of a catheter placement for continuous infusion, CPT code 64463 is to be reported. These services are unilateral services, if performed bilaterally modifier 50, or RT / LT would be applicable per payer guidelines.


NOTE: Use of imaging guidance, both ultrasound (76942) and fluoroscopy (77002 and 77003) are included and should not be reported separately.


Please feel free to write if you have any further questions.



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