2025 CPT code 64489

Bilateral transversus abdominis plane (TAP) block using continuous infusions; includes imaging guidance when performed.

Imaging guidance is included in this code and should not be billed separately.Modifier 50 is used for bilateral procedures.

Modifier 50 should be appended for bilateral procedures.Other modifiers may be appropriate depending on the circumstances of service, such as those related to anesthesia.

Medical necessity for a TAP block is established when the patient is experiencing or anticipated to experience significant post-operative pain or chronic abdominal pain. The block should be medically appropriate based on patient condition and anticipated pain levels.

The physician is responsible for performing the TAP block, which includes prepping the patient, marking the injection sites, inserting the catheter, securing it, administering the anesthetic via continuous infusion, monitoring the infusion, removing the catheter, and applying a dressing to the injection site.The physician may also utilize imaging guidance during the procedure.

IMPORTANT For unilateral TAP block via injection, use 64486. For unilateral TAP block via infusion, use 64487. For bilateral TAP block via injection, use 64488.

In simple words: This code describes a procedure to reduce pain after surgery in the lower abdomen.A thin tube is placed on both sides of the belly to deliver pain medicine continuously.Doctors may use imaging, like ultrasound, to help place the tube. The tube stays in place for pain control.

This CPT code 64489 reports a bilateral transversus abdominis plane (TAP) block, achieved via continuous infusions of an anesthetic agent.The procedure involves injecting the anesthetic into the interfascial plane between the transversus abdominis and internal oblique muscles, bilaterally.Imaging guidance, such as ultrasound or fluoroscopy, may be utilized, and is considered an inclusive component of this code.The procedure aims to provide analgesia to the anterior abdominal wall. One or more continuous infusions are encompassed within this single code.

Example 1: A patient undergoes a lower abdominal surgery. A TAP block is performed before surgery to reduce postoperative pain. Continuous infusion is chosen for longer-lasting analgesia., A patient is admitted for post-surgical pain management, specifically for pain in the lower abdomen. A bilateral TAP block with continuous infusion is performed to provide prolonged pain relief., A patient experiences chronic abdominal pain. A TAP block with continuous infusion is performed to provide prolonged relief, and ultrasound is used for precise catheter placement.

Detailed operative notes, including the specific anesthetic used, catheter placement details, infusion rate, and duration of infusion.Imaging reports (if ultrasound or other imaging was used).Documentation of patient response to the block (pain levels before and after).Note that imaging guidance is considered inclusive and should not be billed separately.

** This code describes a continuous infusion technique.Multiple infusions within the same bilateral procedure are not separately reported.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.