2025 CPT code 64416

Injection of anesthetic and/or steroid into the brachial plexus by continuous infusion via catheter, including imaging guidance.

Imaging guidance is included in the code and should not be reported separately. For bilateral procedures, use modifier 50.

Modifiers may be applicable. Modifier 50 is used for bilateral procedures.

Medical necessity for this procedure must be clearly established. This includes documentation of the underlying condition causing pain, failed attempts at less invasive treatments, and anticipated benefit of continuous infusion.

The physician is responsible for prepping and anesthetizing the patient, inserting the catheter, confirming its placement, injecting the medication, and managing the continuous infusion.

IMPORTANT For injections without continuous infusion, see 64415. For destruction by neurolytic agent or chemodenervation, see 62280-62282, 64600-64681. For epidural or subarachnoid injection, see 62320-62327. For intracranial surgery on cranial nerves, see 61450, 61460, 61790.

In simple words: A catheter is inserted into the network of nerves in your neck and shoulder area that supply your arm (brachial plexus). Pain medication and/or anti-inflammatory medicine is continuously delivered through this catheter to provide ongoing pain relief.

This code describes the placement of a catheter for continuous infusion of anesthetic agent(s) and/or steroid into the brachial plexus. Imaging guidance is included when performed. This procedure involves inserting a catheter into the brachial plexus region, often using a needle-tipped catheter. Once correctly positioned, the needle is removed, leaving the catheter in place. Anesthetic and/or steroid is then injected, and a continuous infusion is started. The procedure also includes daily management for anesthetic agent administration.

Example 1: A patient with complex regional pain syndrome experiences severe, persistent pain in their arm. A brachial plexus catheter is placed for continuous infusion of anesthetic and steroid to manage the pain., Following shoulder surgery, a patient has significant postoperative pain. A continuous brachial plexus block is initiated to provide extended pain relief during recovery., A patient with intractable cancer-related arm and shoulder pain requires continuous anesthetic infusion via a brachial plexus catheter for palliative care.

Documentation should include details of the procedure, type and amount of medication used, imaging guidance if performed, patient response, and any complications. Medical necessity for the continuous infusion should also be documented.

** Code 76942 (Ultrasound guidance for needle placement) should not be reported separately with 64416 as imaging guidance is included.

  • Payment Status: Active
  • Specialties:Anesthesiology, Pain Management, Surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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