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Sphenopalatine Block using Q-tips

Pauline Posted Thu 19th of November, 2015 17:26:54 PM

Our physician did a Spehnopalatine Block using Q-tips soaked in Lidocaine and gradually introduced into the nose until rested on the sphenopalatine. Is this procedure billable? What would be the procedure code? 64505 is for an injection which was not done. Is this procedure considered part of the E&M visit and therefore included in the E&M codes?

SuperCoder Answered Fri 20th of November, 2015 03:15:35 AM

Hi Pauline,

According to our CPT Advisors and from a CPT coding perspective, it would not be appropriate to report code 64505, Injection, anesthetic agent; sphenopalatine ganglion, as this code represents a procedure requiring the performance of an “injection”. Therefore, the insertion of the Lidocaine soaked Q-tip in the nostril is not reported separately by any specific CPT code, and would be considered inclusive of an appropriate level E/M, as appropriate.

Alternatively, if performed in the absence of an accompanying E/M service, the unlisted code 30999, Unlisted procedure, nose, or 64999, Unlisted procedure, nervous system, should be reported. Respectfully, CPT Education and Information Services.”

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