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The procedure described by CPT® Code 64416 involves the injection of anesthetic agents and/or steroids into the brachial plexus through a continuous infusion method. This procedure, commonly referred to as a nerve block, serves both diagnostic and therapeutic purposes. The brachial plexus is a network of nerves that originates from the spinal cord and extends into the arm, providing motor and sensory function. The injection is performed with the arm in an abducted position, the elbow flexed, and the hand elevated above the shoulder to facilitate access to the brachial plexus. Prior to the injection, the skin is thoroughly cleansed and anesthetized to minimize discomfort. A needle is then inserted into either the infraclavicular or supraclavicular region, and advanced carefully into the brachial plexus sheath. To ensure accurate placement, the needle's position is confirmed through electrical nerve stimulation or by observing the onset of sensory changes such as numbness or tingling. Imaging guidance, such as ultrasound, may also be utilized to enhance precision. Once the needle is correctly positioned, a cannula is threaded over the needle into the brachial plexus sheath, and the needle is subsequently removed. An epidural-type catheter is then introduced through the cannula to facilitate the continuous infusion of the anesthetic agent, which is typically a local anesthetic like lidocaine or bupivacaine. The effectiveness of the nerve block is assessed, and the continuous infusion is initiated to provide ongoing pain relief or anesthesia.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 64416 is indicated for various conditions that may require pain management or diagnostic evaluation related to the brachial plexus. The following are explicitly provided indications for this procedure:
The procedure for CPT® Code 64416 involves several detailed steps to ensure proper administration of the anesthetic agent and/or steroid. The following procedural steps are outlined:
After the completion of the procedure, the patient is monitored for any immediate adverse reactions or complications. It is essential to assess the effectiveness of the nerve block, which may include evaluating the patient's pain levels and sensory function in the affected arm. Patients may be advised on post-procedure care, which could include instructions on activity restrictions, signs of potential complications to watch for, and follow-up appointments for further evaluation or adjustments to the pain management plan. The duration of the anesthetic effect and the continuous infusion will be discussed, along with any necessary adjustments based on the patient's response to the treatment.
| Short Descr | NJX AA&/STRD BRCH PL NFS IMG | Medium Descr | INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG | Long Descr | Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 5 - Insertion of catheter or spinal stimulator and injection into spinal canal |
This is a primary code that can be used with these additional add-on codes.
| 77002 | CPT Add On MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (List separately in addition to code for primary procedure) |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | GC | This service has been performed in part by a resident under the direction of a teaching physician | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AG | Primary physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | SG | Ambulatory surgical center (asc) facility service |
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| 2023-01-01 | Changed | Code description changed. |
| 2020-01-01 | Changed | Code description changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2009-01-01 | Changed | Code description changed |
| 2003-01-01 | Added | First appearance in code book in 2003. |