This month, in “Spotlight on CPT”, the discussion will center on fascial plane blocks (FPB). To begin, fascial plane blocks are a type of regional anesthetic. Fascial layers within the body are sheets of connective tissue. These fascial sheets protect and separate Internal organs and muscles. The space between the layers, known as the plane, provides cushioning for the internal structures and is a pathway for vessels and nerves. Because of the proximity to the nerve pathway, FPBs can be used during or post-procedure for pain relief.
Source: https://www.facebook.com/ClinAnat.OperSurg/posts/layers-of-the-chest-wall-intercostal-spacethe-chest-wall-can-be-divided-into-thr/3291308170902159/
There are a number of different FPBs that can be performed. These include:
In the CPT code updates for 2025, new codes were added to capture FPBs.
Notice that codes 64466-64469 are specifically for an FPB in the thoracic region. Two distinctions exist for the codes. First, is the procedure unilateral or bilateral? Second, was the procedure a single injection or continuous infusion?
Interestingly, when we get to 64473-64474 for the lower extremity FPB there is a slight change. While we still need to distinguish if the procedure was done by injection or infusion, there are only codes for a unilateral procedure.
None of these new codes should be used with codes from the Radiology section for imaging guidance including fluoroscopy, ultrasound, CT, or MRI since the use of imaging guidance is included in the code descriptor.
Source: https://www.facebook.com/ClinAnat.OperSurg/posts/layers-of-the-chest-wall-intercostal-spacethe-chest-wall-can-be-divided-into-thr/3291308170902159/
There are a number of different FPBs that can be performed. These include:
Parasternal-intercostal
Serratus
Retrolaminar
Trapezius muscle
Rhomboid major muscle
Erector spinae muscle
Serratus anterior muscle
Pectoralis minor muscle
Transversus thoracis muscle
In the CPT code updates for 2025, new codes were added to capture FPBs.
64466 Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed
64467 by continuous infusion(s), including imaging guidance, when performed
64468 Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed
64469 by continuous infusion(s), including imaging guidance, when performed
64473 Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed
64474 by continuous infusion(s), including imaging guidance, when performed
Notice that codes 64466-64469 are specifically for an FPB in the thoracic region. Two distinctions exist for the codes. First, is the procedure unilateral or bilateral? Second, was the procedure a single injection or continuous infusion?
Interestingly, when we get to 64473-64474 for the lower extremity FPB there is a slight change. While we still need to distinguish if the procedure was done by injection or infusion, there are only codes for a unilateral procedure.
None of these new codes should be used with codes from the Radiology section for imaging guidance including fluoroscopy, ultrasound, CT, or MRI since the use of imaging guidance is included in the code descriptor.
Now, light has been shed on coding fascial plane blocks.
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