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Official Description

Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The transversus abdominis plane (TAP) block, identified by CPT® Code 64486, is a regional anesthesia technique that targets the nerves supplying the anterior abdominal wall, specifically at the levels of T6 to L1. This procedure is utilized primarily as an adjunct therapy to manage postoperative pain in patients undergoing abdominal surgery. The TAP block can be administered at various stages of the surgical process, including preoperatively, intraoperatively, or postoperatively, depending on the clinical scenario and the patient's needs. A unilateral TAP block is particularly effective when the surgical incision is positioned to the right or left of the midline, allowing for targeted pain relief in the affected area. The procedure typically involves the injection of a long-acting local anesthetic, such as bupivacaine, which can provide significant pain relief for up to 36 hours following a single injection. In cases where continuous infusion is employed, pain relief may extend from 36 to 72 hours, enhancing patient comfort during recovery. For incisions located in the midline of the abdomen, a bilateral TAP block may be indicated to ensure comprehensive analgesia. Various approaches can be utilized for the TAP block, often guided by ultrasound, which enhances the precision of needle placement and the effectiveness of the anesthetic delivery. These approaches include subcostal, oblique subcostal, lateral, and posterior techniques, each tailored to the specific anatomy and surgical requirements of the patient.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The transversus abdominis plane (TAP) block is indicated for the following conditions:

  • Postoperative Pain Control This procedure is commonly performed to manage pain following abdominal surgeries, providing effective analgesia to enhance patient comfort during recovery.
  • Adjunct Therapy in Abdominal Surgery The TAP block serves as an adjunct to general anesthesia, helping to reduce the overall requirement for systemic opioids and minimizing potential side effects associated with their use.
  • Unilateral Pain Management It is particularly beneficial for patients with surgical incisions located to the right or left of the midline, allowing for targeted pain relief in the affected area.

2. Procedure

The procedure for performing a unilateral transversus abdominis plane (TAP) block involves several key steps:

  • Identification of the Triangle of Petit The clinician begins by locating the triangle of Petit, which is an anatomical landmark used to guide the needle insertion. This area is situated cephalad to the iliac crest and near the midaxillary line.
  • Needle Insertion A needle is inserted perpendicular to the skin at the identified site. The clinician carefully advances the needle through the external and internal abdominal oblique muscles until it reaches the fascia above the transversus abdominis muscle.
  • Injection of Local Anesthetic Once the needle is in the correct position, local anesthetic is injected at measured intervals. The clinician performs aspiration prior to each injection to confirm that the needle is not within a blood vessel, ensuring patient safety.
  • Continuous Infusion Setup (if applicable) For TAP blocks utilizing continuous infusion, ultrasound guidance is typically employed. The physician visualizes the muscle layers and fascia, allowing for precise placement of the Tuohy needle into the fascia above the transversus abdominis muscle.
  • Hydrodissection The clinician hydrodissects the transversus abdominis plane (TAP) by injecting 10 ml of isotonic saline, which helps to create a space for the subsequent catheter placement.
  • Catheter Placement An epidural catheter is introduced through the Tuohy needle and advanced 10 to 20 cm into the TAP. After confirming the correct placement, the Tuohy needle is removed, and the catheter is secured to the skin.
  • Administration of Anesthetic A bolus injection of local anesthetic is administered through the catheter, and the infusion is monitored using ultrasound to ensure proper delivery. This process may be repeated on the opposite side for a bilateral block.

3. Post-Procedure

After the transversus abdominis plane (TAP) block is performed, patients can expect a period of effective pain relief, which may last from 36 to 72 hours depending on whether a single injection or continuous infusion is utilized. Post-procedure care includes monitoring for any potential complications, such as infection or hematoma at the injection site. Patients should be assessed for the effectiveness of pain control and any side effects from the local anesthetic. Continuous infusion catheters should be managed according to established protocols, ensuring that the anesthetic is delivered safely and effectively throughout the recovery period.

Short Descr TAP BLOCK UNIL BY INJECTION
Medium Descr TAP BLOCK UNILATERAL BY INJECTION(S)
Long Descr Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes 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 Items and Services Packaged into APC Rates
ASC Payment Indicator Packaged service/item; no separate payment made.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor procedures - musculoskeletal
MUE 1
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)
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
LT Left side (used to identify procedures performed on the left side of the body)
GC This service has been performed in part by a resident under the direction of a teaching physician
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
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).
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
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).
SG Ambulatory surgical center (asc) facility service
Q3 Live kidney donor surgery and related services
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
47 Anesthesia by surgeon: regional or general anesthesia provided by the surgeon may be reported by adding modifier 47 to the basic service. (this does not include local anesthesia.) note: modifier 47 would not be used as a modifier for the anesthesia procedures.
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
56 Preoperative management only: when 1 physician or other qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure, the preoperative component may be identified by adding modifier 56 to the usual procedure number.
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.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
U1 Medicaid level of care 1, as defined by each state
X2 Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services
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
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2015-01-01 Added Added
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