2025 CPT code 64463
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Paravertebral block (PVB), thoracic; third and any additional injection sites; includes imaging guidance, when performed.
Modifier 50 (bilateral procedure) may apply if injections are performed on both sides of the spine.Add-on codes 64462 should be reported twice if used bilaterally. Do not use modifier 50 with add-on codes.
Medical necessity is established through documentation supporting the diagnosis of a treatable condition causing pain in the thoracic region that has not responded to other less invasive treatments. The procedure should be medically appropriate given the patient's condition and prognosis.
The physician is responsible for performing the injections, which requires expertise in regional anesthesia and knowledge of relevant anatomy. Pre-procedure patient assessment, including any potential contraindications, is crucial. Post-procedure monitoring is also part of the clinical responsibility to detect and treat any adverse effects.
In simple words: The doctor uses imaging to guide injections of medicine (like numbing medicine or steroids) near the spine in the upper/middle back area to relieve pain or reduce swelling.This code is for the third and any extra shots after the first two.
This CPT code, 64463, represents the performance of a paravertebral block (PVB), specifically targeting the thoracic region, involving the third and any subsequent injection sites.The procedure includes imaging guidance such as fluoroscopy or CT when utilized.It is crucial to note that imaging guidance and contrast injections are inclusive components of this code and should not be reported separately.This code is reported only for the third and any additional injection sites beyond the initial two. The initial two injections are separately coded using CPT codes 64461 and 64462.
Example 1: A patient with chronic back pain from degenerative disc disease undergoes a thoracic paravertebral block.The initial two injections provide partial relief; therefore, a third injection is administered using code 64463., A patient post-thoracotomy experiences significant post-surgical pain.After initial pain management with 64461 and 64462, a third injection (64463) is necessary for adequate analgesia., A patient presents with intractable thoracic radiculopathy. A multi-level paravertebral block is performed, necessitating the use of code 64463 for the third and subsequent injection sites.
* Detailed history and physical examination noting the location and nature of the pain.* Documentation of the rationale for performing the block.* Imaging reports (if applicable) and confirmation of needle placement at each injection site.* Type and amount of anesthetic and steroid used for each injection.* Documentation of any complications, adverse effects, or post-procedure pain relief.* Patient's response to the procedure.
** Careful attention should be paid to the correct sequencing of codes 64461, 64462, and 64463 to accurately reflect the number of injection sites.Always consult payer-specific guidelines for reimbursement.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- RVU: This information is not available in the provided text.RVUs vary by payer and location. Consult a relevant fee schedule for current values.
- Global Days: The global surgical period for this procedure is not specified in the provided text.The global period will depend on payer policies.
- Payment Status: Active
- Modifier TC rule: Not applicable. TC modifier not relevant for this code.
- Fee Schedule: This information is not available in the provided text. Fee schedules vary by payer and geographic location.
- Specialties:Anesthesiology, Pain Management, Neurosurgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center