2025 CPT code 64421
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Injection(s) of anesthetic agent(s) and/or steroid into each additional intercostal nerve level (List separately in addition to code for primary procedure).
Modifiers may be applicable. Modifier 50 (Bilateral Procedure) should not be used with 64421. If performed bilaterally, report 64421 twice.
Medical necessity must be established for the use of this code.The documentation should clearly demonstrate the clinical rationale for injecting multiple intercostal nerve levels with anesthetic/steroid.The patient’s diagnosis and symptoms must justify the procedure.
The physician prepares the patient and uses a needle and syringe to inject anesthetic and/or steroid near the intercostal nerves to numb the area. This is done to treat pain, assist with surgery, or for diagnostic purposes.
In simple words: The doctor injects medicine near the nerves under your ribs to numb the chest area. This code is for each additional level of nerves injected after the first one.
This code describes the injection of an anesthetic agent and/or steroid into each additional intercostal nerve level beyond the initial level.It is used for multiple injections at different intercostal nerve levels during a single session. Imaging guidance and any injection of contrast are included and not reported separately.This code is an add-on code and should be reported in addition to 64420 (for the first level injected).
Example 1: A patient with chronic pain from shingles receives injections at three intercostal nerve levels.64420 would be reported once, and 64421 would be reported twice (for the second and third levels)., A patient undergoing breast surgery requires anesthetic blockade of two intercostal nerve levels. 64420 would be reported for the first level injected, and 64421 would be reported for the second level., A physician performs diagnostic nerve blocks at four separate intercostal levels to determine the source of a patient's chest pain. 64420 is reported once, and 64421 is reported three times.
Documentation should include the specific intercostal nerve levels injected, the type of anesthetic and/or steroid used, the indication for the procedure (e.g., pain management, surgical anesthesia, diagnosis), and any imaging guidance used. The medical record should support the medical necessity of the procedure.
- Revenue Code: P6C - Minor Procedures - Other (Medicare Fee Schedule)
- Payment Status: Active
- Specialties:Anesthesiology, Pain Management, Surgery (Thoracic, General, etc.)
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Office