Medical Billing

# Coding the Suprascapular Nerve Block: Mastering the CPT Code for Pain Relief

- October 22, 2024
- Posted by Kristen Edwards

15 Dec

The Suprascapular nerve block is a safe and effective way to treat pain in the shoulder and arm. It is a minimally invasive procedure that can be performed in an outpatient setting. The procedure is performed under fluoroscopic guidance to ensure accuracy.

The CPT code for Suprascapular nerve block is 64450. This code is used to describe the injection of medication into the suprascapular nerve, which is located in the shoulder. This nerve block’s purpose is to relieve pain in the shoulder and arm. Also, this code reports an anesthetic agent and a steroid injected into the suprascapular notch. The suprascapular notch is a depression on the scapula that is located at the junction of the transverse and vertical facets. The suprascapular nerve moves through this notch.

If you are experiencing pain in the shoulder and arm and would like to learn more about the Suprascapular nerve block, keep reading to know how your provider will code your condition using CPT codes.

## How CPT code 64450 is billed for the Suprascapular Nerve Block?

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CPT code 64450 (Injection)s; diagnostic or therapeutic agent, anaesthetic/steroid, perineural) may be billed for a suprascapular nerve block. CPT code 64450 (Suprascapular nerve block) can be billed for when the physician provides a suprascapular nerve block. This nerve block is performed to help relieve pain in the shoulder area. The physician will inject a local anaesthetic into the suprascapular nerve, which will block the pain signals from this nerve. This procedure is usually performed on an outpatient basis.

## What Procedure Code is 64400?

Procedure code 64400 is a medical code that is used to describe a nerve block procedure. This procedure is used to block the transmission of pain signals from the nerves to the brain. This can be done for a variety of reasons, such as to relieve pain from an injury or to allow a patient to have surgery without feeling pain.

## What Procedure Code is 62270?

Procedure code 62270 is a code used to indicate a medical procedure known as a lumbar puncture. This procedure is also sometimes referred to as a spinal tap. It is a procedure that is used to collect cerebrospinal fluid (CSF) from the spinal cord for diagnostic testing.

In order to perform a lumbar puncture, a needle is inserted into the lower back, between the vertebrae. This needle is then used to collect a small sample of CSF. The CSF is then sent to a lab for testing. The results of these tests can be used to diagnose various conditions, such as infection, inflammation, and tumors.

### Does Medical Insurance Cover Nerve Block Treatment?

If you’re considering a nerve block for pain relief, you may wonder if your insurance will cover the procedure. The answer depends on your insurance carrier and policy, but in most cases, nerve blocks are considered medically necessary and are therefore covered by insurance.

Of course, it’s always best to check with your carrier beforehand to find out if they cover nerve blocks. You can also ask your doctor or pain specialist if they have any recommendations for insurance carriers that cover the procedure.

In general, nerve blocks are a safe and effective way to treat pain. If you’re considering the procedure, be sure to check with your insurance carrier to see if they will cover it.

### Does Medicare cover nerve block treatment?

Medicare is a federal health insurance program that provides coverage for seniors and disabled Americans. Part of Medicare coverage includes medical procedures and treatments that are considered medically necessary. Nerve blocks are considered medically necessary in certain cases and are therefore covered by Medicare.

There are some exceptions and limitations to Medicare coverage for nerve blocks, so it’s important to talk to your doctor and Medicare representative to see if you qualify for coverage. If you do have coverage, there may be some cost-sharing associated with the procedure.

Nerve blocks are a type of pain relief treatment that can be used to relieve pain caused by conditions like arthritis, shingles, and migraines. While nerve blocks are generally safe and effective, they can be expensive. Medicare does not typically cover the cost of nerve blocks, but there are some exceptions. If you have Medicare and are considering a nerve block, be sure to check with your doctor or healthcare provider to see if you may be covered.

### How is the Interscalene block different from the supraclavicular block?

There are two main types of brachial plexus blocks: supraclavicular and Interscalene. The former is performed at the base of the neck, just above the clavicle, while the latter is performed higher up, at the level of the shoulder.

The main difference between these two types of blocks is the area of anesthesia. With a supraclavicular block, the anaesthesia will primarily affect the shoulder and arm. With an Interscalene block, the anesthesia will extend down to the hand. This makes an Interscalene block more suitable for procedures that involve the hand or forearm, such as carpal tunnel surgery.

Both supraclavicular and Interscalene blocks are effective methods of providing anesthesia for upper extremity surgery.

CPT code for interscalene block

The CPT code for a single injection of the brachial plexus used in shoulder procedures is 64415, while catheter insertion for the same procedure is represented by the corresponding code 64416.

### CPT Code Series For A Regional Nerve Block

The Current Procedural Terminology (CPT) codes for regional nerve block are 01969, 01967, and 01968. These codes are used to report a diagnostic or therapeutic block of a peripheral nerve or ganglion and also to describe a procedure in which a local anesthetic is injected near a specific nerve or group of nerves to block pain signals from that area. Regional nerve blocks are commonly used to treat pain in the arms, legs, or trunk.

### CPT Code Series For Medial Branch Block

The CPT code for medial branch block and the fact joint injections consist of a series from 64490-64495. These codes are used to describe a procedure whereby a local anesthetic is injected into the medial branch nerves to block pain signals from reaching the brain. This procedure is often used to diagnose or treat pain associated with the facet joints.

If the patient experiences pain relief from the injection, then a more permanent treatment, such as radiofrequency ablation, can be performed.

### Conclusion

When you are experiencing severe nerve pain that hinders your work, the first thing should you do is to see your healthcare provider and ask for a possible and instant solution. Research the treatment and inquire with the insurance provider about the coverage to get started. Also read our other blogs to know more about Optometry Billing, Medicare Telehealth Reimbursement CPTs, Chiropractor’s CPTs and errors in medical billing.

## FAQs – Interscalene & Suprascapular Nerve Block

### 1. What is a supraclavicular nerve block?

A supraclavicular nerve block is a technique that involves injecting anesthetic near the supraclavicular nerves, which are positioned right next to the clavicle (collarbone), in order to numb the nerves that provide feeling and function to the arm, forearm, and hand. It is frequently utilized in upper extremity surgeries.

### 2. Are there risks associated with a supraclavicular nerve block?

Yes, while typically safe, the following potential dangers exist:

- Infection of the injection site.
- Bleeding or hematoma.
- Nerve injuries can be temporary or permanent.
- Pneumothorax (a rare lung damage).

### 3. How should I prepare for a supraclavicular nerve block?

You should adhere to the preoperative recommendations supplied by your doctor. Typically, this includes:

- If sedation or general anesthesia is used, a period of fasting may be required before the treatment.
- Inform your doctor about any drugs you take, especially blood thinners, since they may need to be changed.

### 4. What are the alternatives to a supraclavicular nerve block?

Choices are:

- General anesthesia impacts every part of the body but has lengthier recovery durations.
- Regional blocks may include interscalene, infraclavicular, or axillary blocks, depending on the operative site. Your anesthesiologist will talk about the best options according to what’s needed and your medical history.

### 5. Who is qualified to perform a supraclavicular nerve block?

Supraclavicular nerve blocks are normally administered by anesthesiologists or certified registered nurse anesthetists (CRNAs) who have received advanced training in regional anesthetic procedures. They may also employ ultrasonography to guarantee accurate administration.

### 6. Will my insurance cover the suprascapular nerve block?

Most insurance companies will fund suprascapular nerve blocks if they are medically necessary. The operation is frequently billed using supraclavicular nerve block CPT code 64418. It is always advisable to verify with your insurance carrier for precise coverage information.

### 7. How effective is the suprascapular nerve block?

The efficacy of the suprascapular nerve block varies with the individual and the disease. Many patients report great pain reduction and better function after the surgery. Clinical investigations have indicated that it can be a useful treatment for numerous shoulder-related disorders.

### 8. CPT code for interscalene nerve block 64415

An Interscalene Nerve Block is a form of regional anesthetic that affects the brachial plexus nerves around the neck, specifically at the interscalene groove, to relieve discomfort during shoulder and upper arm procedures. It is mostly utilized for shoulder arthroscopy, rotator cuff repair, and other upper extremity surgery. The procedure works by injecting an anesthetic substance over the brachial plexus nerves, which temporarily numbs the shoulder and upper arm. While it provides good pain relief for these surgeries, it may cause transient diaphragmatic paralysis (due to phrenic nerve involvement), making it unsuitable for patients who have pre-existing breathing issues. The CPT code for this kind of surgery is 64415, which relates to the injection of an anesthesia drug into the brachial plexus, which is located at the interscalene level.

### 9. Does the interscalene block CPT code 64415 include imaging guidance?

Yes, if imaging guidance, such as ultrasonography, is used throughout the procedure, it is covered by the interscalene block CPT code 64415. This ensures that the anesthetic is properly placed near the brachial plexus nerves.

### 10. Can the interscalene nerve block CPT code be billed separately from the surgery?

Yes, if the interscalene nerve block CPT is administered for postoperative pain management rather than intraoperative anesthesia, CPT code 64415 may be paid separately. The nerve block’s purpose must be stated explicitly in the documentation.

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