Regional Anesthesiology entails injecting a local anesthetic near nerves to numb a portion of the

body. There are several types of regional anesthetics including spinal anesthesia, epidural
anesthesia and various specific nerve blocks. When Regional Anesthesia is used,
patients may be awake, sedated or put to sleep for their surgical procedure.
Nerve Blocks are used to block pain at a specific site. By injecting a local anesthetic into or
around a specific nerve or group of nerves, pain relief can be localized to the site of pain. This
type of anesthesia provides pain control during and after a procedure, It is associated with
minimal side effects. Examples of nerve blocks include an adductor canal nerve block for knee
surgery, an interscalene nerve block for shoulder surgery, and a supraclavicular nerve block for
arm surgery.

Interscalene nerve block refers to the technique of anesthetizing the roots or

trunks of the brachial plexus in the neck between the anterior and middle
scalene muscles
Details to determine accurate cpt code
Scenario, diagnosis making procedure necessary.

The pain associated with a rotator cuff injury may:

 Be described as a dull ache deep in the shoulder

 Disturb sleep, particularly if you lie on the affected shoulder

 Make it difficult to comb your hair or reach behind your back

 Be accompanied by arm weakness

 octors use a medical history, a physical exam, and imaging scans to

diagnose rotator cuff injuries. They may ask about physical activities at
the workplace. These questions determine whether a patient has an
increased risk for a degenerative condition.
 Your doctor will also test the arm’s range of motion and strength. They
will also rule out similar conditions, such as a pinched nerve or arthritis.
 Imaging scans, such as an X-ray, can identify any bone spurs. These
small bone growths can rub against the rotator cuff tendon and cause
pain and inflammation.
 Magnetic resonance imaging (MRI) or ultrasound scans can also be
used. These tools examine soft tissues, including the tendons and
 muscles. They can help identify tears, as well as show how large and
severe the tears have become.

Accurate cpt code

Code the initial interscalene block with 64415* (Injection, anesthetic agent; brachial plexus, single).
Report CPT 64416 ( brachial plexus, continuous infusion by catheter [including catheter placement]
including daily management for anesthetic agent administration) for post-op pain management. This
new code has a 10-day global period.
Anesthesiologists typically report CPT 64415* (Injection, anesthetic agent; brachial plexus, single) or
64416 (... brachial plexus, continuous infusion by catheter [including catheter placement] including
daily management for anesthetic agent administration) for brachial plexus blocks with anesthetic
agents. Determine whether the physician placed a catheter or performed a single injection for
postoperative pain and administered general anesthesia, or whether the physician provided
anesthesia with the brachial plexus block.
The interscalene block is one approach for a brachial plexus nerve block. Your best choices
therefore are 64415 (brachial plexus single) and 64416 (brachial plexus continuous infusion by
catheter [including catheter placement] including daily management for anesthetic agent
administration).

RT Right side (used to identify

procedures performed on the
right side of the body)

Synonyms Injection of anesthetic agent into

brachial plexus

Single injection of anesthetic

agent into brachial plexus

SINGLE NERVE BLOCK

INJECTION ARM NERVE

Injection of anesthetic agent,

brachial (arm) nerve bundle