LCD Reference Article Billing and Coding Article

Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)

A56607

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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Source Article ID
N/A
Article ID
A56607
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
Article Type
Billing and Coding
Original Effective Date
06/06/2019
Revision Effective Date
05/25/2023
Revision Ending Date
N/A
Retirement Date
N/A

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CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833(e) states that no payment shall be made to any provider for any claim which lacks the necessary information to process the claim.

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 23, §20.9 National Correct Coding Initiative (NCCI)

Article Guidance

Article Text

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Continuous Peripheral Nerve Blocks (CPNB) L37641.

Limitations

Reimbursement for the control or management of pain in the immediate postoperative period is bundled into the payment for the procedure, surgical or anesthetic - regardless of the method by which the care provider, including the anesthesiologist, decides to manage pain.

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ICD-10-CM Codes that Support Medical Necessity

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Group 1 Codes
Code Description
B02.1 Zoster meningitis
B02.21 Postherpetic geniculate ganglionitis
B02.22 Postherpetic trigeminal neuralgia
B02.23 Postherpetic polyneuropathy
B02.24 Postherpetic myelitis
B02.29 Other postherpetic nervous system involvement
B02.7 Disseminated zoster
B02.8 Zoster with other complications
B02.9 Zoster without complications
E08.41 Diabetes mellitus due to underlying condition with diabetic mononeuropathy
E08.44 Diabetes mellitus due to underlying condition with diabetic amyotrophy
E09.41 Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy
E09.44 Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy
E10.41 Type 1 diabetes mellitus with diabetic mononeuropathy
E10.44 Type 1 diabetes mellitus with diabetic amyotrophy
E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy
E11.44 Type 2 diabetes mellitus with diabetic amyotrophy
E13.41 Other specified diabetes mellitus with diabetic mononeuropathy
E13.44 Other specified diabetes mellitus with diabetic amyotrophy
G50.0 Trigeminal neuralgia
G54.0 Brachial plexus disorders
G54.1 Lumbosacral plexus disorders
G54.2 Cervical root disorders, not elsewhere classified
G54.3 Thoracic root disorders, not elsewhere classified
G54.4 Lumbosacral root disorders, not elsewhere classified
G54.5 Neuralgic amyotrophy
G54.6 Phantom limb syndrome with pain
G54.8 Other nerve root and plexus disorders
G55 Nerve root and plexus compressions in diseases classified elsewhere
G56.00 Carpal tunnel syndrome, unspecified upper limb
G56.01 Carpal tunnel syndrome, right upper limb
G56.02 Carpal tunnel syndrome, left upper limb
G56.03 Carpal tunnel syndrome, bilateral upper limbs
G56.10 Other lesions of median nerve, unspecified upper limb
G56.11 Other lesions of median nerve, right upper limb
G56.12 Other lesions of median nerve, left upper limb
G56.13 Other lesions of median nerve, bilateral upper limbs
G56.20 Lesion of ulnar nerve, unspecified upper limb
G56.21 Lesion of ulnar nerve, right upper limb
G56.22 Lesion of ulnar nerve, left upper limb
G56.23 Lesion of ulnar nerve, bilateral upper limbs
G56.30 Lesion of radial nerve, unspecified upper limb
G56.31 Lesion of radial nerve, right upper limb
G56.32 Lesion of radial nerve, left upper limb
G56.33 Lesion of radial nerve, bilateral upper limbs
G56.40 Causalgia of unspecified upper limb
G56.41 Causalgia of right upper limb
G56.42 Causalgia of left upper limb
G56.43 Causalgia of bilateral upper limbs
G56.80 Other specified mononeuropathies of unspecified upper limb
G56.81 Other specified mononeuropathies of right upper limb
G56.82 Other specified mononeuropathies of left upper limb
G56.83 Other specified mononeuropathies of bilateral upper limbs
G56.90 Unspecified mononeuropathy of unspecified upper limb
G56.91 Unspecified mononeuropathy of right upper limb
G56.92 Unspecified mononeuropathy of left upper limb
G56.93 Unspecified mononeuropathy of bilateral upper limbs
G57.00 Lesion of sciatic nerve, unspecified lower limb
G57.01 Lesion of sciatic nerve, right lower limb
G57.02 Lesion of sciatic nerve, left lower limb
G57.03 Lesion of sciatic nerve, bilateral lower limbs
G57.10 Meralgia paresthetica, unspecified lower limb
G57.11 Meralgia paresthetica, right lower limb
G57.12 Meralgia paresthetica, left lower limb
G57.13 Meralgia paresthetica, bilateral lower limbs
G57.20 Lesion of femoral nerve, unspecified lower limb
G57.21 Lesion of femoral nerve, right lower limb
G57.22 Lesion of femoral nerve, left lower limb
G57.23 Lesion of femoral nerve, bilateral lower limbs
G57.30 Lesion of lateral popliteal nerve, unspecified lower limb
G57.31 Lesion of lateral popliteal nerve, right lower limb
G57.32 Lesion of lateral popliteal nerve, left lower limb
G57.33 Lesion of lateral popliteal nerve, bilateral lower limbs
G57.40 Lesion of medial popliteal nerve, unspecified lower limb
G57.41 Lesion of medial popliteal nerve, right lower limb
G57.42 Lesion of medial popliteal nerve, left lower limb
G57.43 Lesion of medial popliteal nerve, bilateral lower limbs
G57.50 Tarsal tunnel syndrome, unspecified lower limb
G57.51 Tarsal tunnel syndrome, right lower limb
G57.52 Tarsal tunnel syndrome, left lower limb
G57.53 Tarsal tunnel syndrome, bilateral lower limbs
G57.60 Lesion of plantar nerve, unspecified lower limb
G57.61 Lesion of plantar nerve, right lower limb
G57.62 Lesion of plantar nerve, left lower limb
G57.63 Lesion of plantar nerve, bilateral lower limbs
G57.70 Causalgia of unspecified lower limb
G57.71 Causalgia of right lower limb
G57.72 Causalgia of left lower limb
G57.73 Causalgia of bilateral lower limbs
G57.80 Other specified mononeuropathies of unspecified lower limb
G57.81 Other specified mononeuropathies of right lower limb
G57.82 Other specified mononeuropathies of left lower limb
G57.83 Other specified mononeuropathies of bilateral lower limbs
G57.90 Unspecified mononeuropathy of unspecified lower limb
G57.91 Unspecified mononeuropathy of right lower limb
G57.92 Unspecified mononeuropathy of left lower limb
G57.93 Unspecified mononeuropathy of bilateral lower limbs
G58.0 Intercostal neuropathy
G58.7 Mononeuritis multiplex
G58.8 Other specified mononeuropathies
G58.9 Mononeuropathy, unspecified
G59 Mononeuropathy in diseases classified elsewhere
G89.11 Acute pain due to trauma
G89.12 Acute post-thoracotomy pain
G89.18 Other acute postprocedural pain
G89.21 Chronic pain due to trauma
G89.22 Chronic post-thoracotomy pain
G89.28 Other chronic postprocedural pain
G89.29 Other chronic pain
G89.3 Neoplasm related pain (acute) (chronic)
G90.50 Complex regional pain syndrome I, unspecified
G90.511 Complex regional pain syndrome I of right upper limb
G90.512 Complex regional pain syndrome I of left upper limb
G90.513 Complex regional pain syndrome I of upper limb, bilateral
G90.519 Complex regional pain syndrome I of unspecified upper limb
G90.521 Complex regional pain syndrome I of right lower limb
G90.522 Complex regional pain syndrome I of left lower limb
G90.523 Complex regional pain syndrome I of lower limb, bilateral
G90.529 Complex regional pain syndrome I of unspecified lower limb
G90.59 Complex regional pain syndrome I of other specified site
I73.00 Raynaud's syndrome without gangrene
I73.01 Raynaud's syndrome with gangrene
L74.510 Primary focal hyperhidrosis, axilla
L74.511 Primary focal hyperhidrosis, face
L74.512 Primary focal hyperhidrosis, palms
L74.513 Primary focal hyperhidrosis, soles
L74.519 Primary focal hyperhidrosis, unspecified
M25.511 Pain in right shoulder
M25.512 Pain in left shoulder
M25.519 Pain in unspecified shoulder
M25.551 Pain in right hip
M25.552 Pain in left hip
M25.559 Pain in unspecified hip
M25.561 Pain in right knee
M25.562 Pain in left knee
M25.569 Pain in unspecified knee
M25.59 Pain in other specified joint
M46.1 Sacroiliitis, not elsewhere classified
M50.10 Cervical disc disorder with radiculopathy, unspecified cervical region
M50.11 Cervical disc disorder with radiculopathy, high cervical region
M50.120 Mid-cervical disc disorder, unspecified level
M50.121 Cervical disc disorder at C4-C5 level with radiculopathy
M50.122 Cervical disc disorder at C5-C6 level with radiculopathy
M50.123 Cervical disc disorder at C6-C7 level with radiculopathy
M50.13 Cervical disc disorder with radiculopathy, cervicothoracic region
M51.14 Intervertebral disc disorders with radiculopathy, thoracic region
M51.15 Intervertebral disc disorders with radiculopathy, thoracolumbar region
M51.16 Intervertebral disc disorders with radiculopathy, lumbar region
M51.17 Intervertebral disc disorders with radiculopathy, lumbosacral region
M53.3 Sacrococcygeal disorders, not elsewhere classified
M53.81 Other specified dorsopathies, occipito-atlanto-axial region
M53.82 Other specified dorsopathies, cervical region
M53.83 Other specified dorsopathies, cervicothoracic region
M54.10 Radiculopathy, site unspecified
M54.11 Radiculopathy, occipito-atlanto-axial region
M54.12 Radiculopathy, cervical region
M54.13 Radiculopathy, cervicothoracic region
M54.14 Radiculopathy, thoracic region
M54.15 Radiculopathy, thoracolumbar region
M54.16 Radiculopathy, lumbar region
M54.17 Radiculopathy, lumbosacral region
M54.18 Radiculopathy, sacral and sacrococcygeal region
M54.2 Cervicalgia
M54.30 Sciatica, unspecified side
M54.31 Sciatica, right side
M54.32 Sciatica, left side
M54.40 Lumbago with sciatica, unspecified side
M54.41 Lumbago with sciatica, right side
M54.42 Lumbago with sciatica, left side
M54.50 Low back pain, unspecified
M54.51 Vertebrogenic low back pain
M54.59 Other low back pain
M54.6 Pain in thoracic spine
M54.81 Occipital neuralgia
M79.2 Neuralgia and neuritis, unspecified
M94.0 Chondrocostal junction syndrome [Tietze]
M96.1 Postlaminectomy syndrome, not elsewhere classified
R07.1 Chest pain on breathing
R07.81 Pleurodynia
R10.10 Upper abdominal pain, unspecified
R10.2 Pelvic and perineal pain
R10.30 Lower abdominal pain, unspecified
R25.0 Abnormal head movements
R25.1 Tremor, unspecified
R25.2 Cramp and spasm
R25.3 Fasciculation
R25.8 Other abnormal involuntary movements
R25.9 Unspecified abnormal involuntary movements
R52 Pain, unspecified
R68.84 Jaw pain
S14.2XXA Injury of nerve root of cervical spine, initial encounter
S14.2XXD Injury of nerve root of cervical spine, subsequent encounter
S14.2XXS Injury of nerve root of cervical spine, sequela
S14.3XXA Injury of brachial plexus, initial encounter
S14.3XXD Injury of brachial plexus, subsequent encounter
S14.3XXS Injury of brachial plexus, sequela
S14.4XXA Injury of peripheral nerves of neck, initial encounter
S14.4XXD Injury of peripheral nerves of neck, subsequent encounter
S14.4XXS Injury of peripheral nerves of neck, sequela
S14.5XXA Injury of cervical sympathetic nerves, initial encounter
S14.5XXD Injury of cervical sympathetic nerves, subsequent encounter
S14.5XXS Injury of cervical sympathetic nerves, sequela
S14.8XXA Injury of other specified nerves of neck, initial encounter
S14.8XXD Injury of other specified nerves of neck, subsequent encounter
S14.8XXS Injury of other specified nerves of neck, sequela
S14.9XXA Injury of unspecified nerves of neck, initial encounter
S14.9XXD Injury of unspecified nerves of neck, subsequent encounter
S14.9XXS Injury of unspecified nerves of neck, sequela
S24.2XXA Injury of nerve root of thoracic spine, initial encounter
S24.2XXD Injury of nerve root of thoracic spine, subsequent encounter
S24.2XXS Injury of nerve root of thoracic spine, sequela
S24.3XXA Injury of peripheral nerves of thorax, initial encounter
S24.3XXD Injury of peripheral nerves of thorax, subsequent encounter
S24.3XXS Injury of peripheral nerves of thorax, sequela
S24.4XXA Injury of thoracic sympathetic nervous system, initial encounter
S24.4XXD Injury of thoracic sympathetic nervous system, subsequent encounter
S24.4XXS Injury of thoracic sympathetic nervous system, sequela
S24.8XXA Injury of other specified nerves of thorax, initial encounter
S24.8XXD Injury of other specified nerves of thorax, subsequent encounter
S24.8XXS Injury of other specified nerves of thorax, sequela
S24.9XXA Injury of unspecified nerve of thorax, initial encounter
S24.9XXD Injury of unspecified nerve of thorax, subsequent encounter
S24.9XXS Injury of unspecified nerve of thorax, sequela
S34.21XA Injury of nerve root of lumbar spine, initial encounter
S34.21XD Injury of nerve root of lumbar spine, subsequent encounter
S34.21XS Injury of nerve root of lumbar spine, sequela
S34.22XA Injury of nerve root of sacral spine, initial encounter
S34.22XD Injury of nerve root of sacral spine, subsequent encounter
S34.22XS Injury of nerve root of sacral spine, sequela
S34.4XXA Injury of lumbosacral plexus, initial encounter
S34.4XXD Injury of lumbosacral plexus, subsequent encounter
S34.4XXS Injury of lumbosacral plexus, sequela
S34.5XXA Injury of lumbar, sacral and pelvic sympathetic nerves, initial encounter
S34.5XXD Injury of lumbar, sacral and pelvic sympathetic nerves, subsequent encounter
S34.5XXS Injury of lumbar, sacral and pelvic sympathetic nerves, sequela
S34.6XXA Injury of peripheral nerve(s) at abdomen, lower back and pelvis level, initial encounter
S34.6XXD Injury of peripheral nerve(s) at abdomen, lower back and pelvis level, subsequent encounter
S34.6XXS Injury of peripheral nerve(s) at abdomen, lower back and pelvis level, sequela
S34.8XXA Injury of other nerves at abdomen, lower back and pelvis level, initial encounter
S34.8XXD Injury of other nerves at abdomen, lower back and pelvis level, subsequent encounter
S34.8XXS Injury of other nerves at abdomen, lower back and pelvis level, sequela
S34.9XXA Injury of unspecified nerves at abdomen, lower back and pelvis level, initial encounter
S34.9XXD Injury of unspecified nerves at abdomen, lower back and pelvis level, subsequent encounter
S34.9XXS Injury of unspecified nerves at abdomen, lower back and pelvis level, sequela
S44.00XA Injury of ulnar nerve at upper arm level, unspecified arm, initial encounter
S44.00XD Injury of ulnar nerve at upper arm level, unspecified arm, subsequent encounter
S44.00XS Injury of ulnar nerve at upper arm level, unspecified arm, sequela
S44.01XA Injury of ulnar nerve at upper arm level, right arm, initial encounter
S44.01XD Injury of ulnar nerve at upper arm level, right arm, subsequent encounter
S44.01XS Injury of ulnar nerve at upper arm level, right arm, sequela
S44.02XA Injury of ulnar nerve at upper arm level, left arm, initial encounter
S44.02XD Injury of ulnar nerve at upper arm level, left arm, subsequent encounter
S44.02XS Injury of ulnar nerve at upper arm level, left arm, sequela
S44.10XA Injury of median nerve at upper arm level, unspecified arm, initial encounter
S44.10XD Injury of median nerve at upper arm level, unspecified arm, subsequent encounter
S44.10XS Injury of median nerve at upper arm level, unspecified arm, sequela
S44.11XA Injury of median nerve at upper arm level, right arm, initial encounter
S44.11XD Injury of median nerve at upper arm level, right arm, subsequent encounter
S44.11XS Injury of median nerve at upper arm level, right arm, sequela
S44.12XA Injury of median nerve at upper arm level, left arm, initial encounter
S44.12XD Injury of median nerve at upper arm level, left arm, subsequent encounter
S44.12XS Injury of median nerve at upper arm level, left arm, sequela
S44.20XA Injury of radial nerve at upper arm level, unspecified arm, initial encounter
S44.20XD Injury of radial nerve at upper arm level, unspecified arm, subsequent encounter
S44.20XS Injury of radial nerve at upper arm level, unspecified arm, sequela
S44.21XA Injury of radial nerve at upper arm level, right arm, initial encounter
S44.21XD Injury of radial nerve at upper arm level, right arm, subsequent encounter
S44.21XS Injury of radial nerve at upper arm level, right arm, sequela
S44.22XA Injury of radial nerve at upper arm level, left arm, initial encounter
S44.22XD Injury of radial nerve at upper arm level, left arm, subsequent encounter
S44.22XS Injury of radial nerve at upper arm level, left arm, sequela
S44.30XA Injury of axillary nerve, unspecified arm, initial encounter
S44.30XD Injury of axillary nerve, unspecified arm, subsequent encounter
S44.30XS Injury of axillary nerve, unspecified arm, sequela
S44.31XA Injury of axillary nerve, right arm, initial encounter
S44.31XD Injury of axillary nerve, right arm, subsequent encounter
S44.31XS Injury of axillary nerve, right arm, sequela
S44.32XA Injury of axillary nerve, left arm, initial encounter
S44.32XD Injury of axillary nerve, left arm, subsequent encounter
S44.32XS Injury of axillary nerve, left arm, sequela
S44.40XA Injury of musculocutaneous nerve, unspecified arm, initial encounter
S44.40XD Injury of musculocutaneous nerve, unspecified arm, subsequent encounter
S44.40XS Injury of musculocutaneous nerve, unspecified arm, sequela
S44.41XA Injury of musculocutaneous nerve, right arm, initial encounter
S44.41XD Injury of musculocutaneous nerve, right arm, subsequent encounter
S44.41XS Injury of musculocutaneous nerve, right arm, sequela
S44.42XA Injury of musculocutaneous nerve, left arm, initial encounter
S44.42XD Injury of musculocutaneous nerve, left arm, subsequent encounter
S44.42XS Injury of musculocutaneous nerve, left arm, sequela
S44.50XA Injury of cutaneous sensory nerve at shoulder and upper arm level, unspecified arm, initial encounter
S44.50XD Injury of cutaneous sensory nerve at shoulder and upper arm level, unspecified arm, subsequent encounter
S44.50XS Injury of cutaneous sensory nerve at shoulder and upper arm level, unspecified arm, sequela
S44.51XA Injury of cutaneous sensory nerve at shoulder and upper arm level, right arm, initial encounter
S44.51XD Injury of cutaneous sensory nerve at shoulder and upper arm level, right arm, subsequent encounter
S44.51XS Injury of cutaneous sensory nerve at shoulder and upper arm level, right arm, sequela
S44.52XA Injury of cutaneous sensory nerve at shoulder and upper arm level, left arm, initial encounter
S44.52XD Injury of cutaneous sensory nerve at shoulder and upper arm level, left arm, subsequent encounter
S44.52XS Injury of cutaneous sensory nerve at shoulder and upper arm level, left arm, sequela
S44.8X1A Injury of other nerves at shoulder and upper arm level, right arm, initial encounter
S44.8X1D Injury of other nerves at shoulder and upper arm level, right arm, subsequent encounter
S44.8X1S Injury of other nerves at shoulder and upper arm level, right arm, sequela
S44.8X2A Injury of other nerves at shoulder and upper arm level, left arm, initial encounter
S44.8X2D Injury of other nerves at shoulder and upper arm level, left arm, subsequent encounter
S44.8X2S Injury of other nerves at shoulder and upper arm level, left arm, sequela
S44.8X9A Injury of other nerves at shoulder and upper arm level, unspecified arm, initial encounter
S44.8X9D Injury of other nerves at shoulder and upper arm level, unspecified arm, subsequent encounter
S44.8X9S Injury of other nerves at shoulder and upper arm level, unspecified arm, sequela
S44.90XA Injury of unspecified nerve at shoulder and upper arm level, unspecified arm, initial encounter
S44.90XD Injury of unspecified nerve at shoulder and upper arm level, unspecified arm, subsequent encounter
S44.90XS Injury of unspecified nerve at shoulder and upper arm level, unspecified arm, sequela
S44.91XA Injury of unspecified nerve at shoulder and upper arm level, right arm, initial encounter
S44.91XD Injury of unspecified nerve at shoulder and upper arm level, right arm, subsequent encounter
S44.91XS Injury of unspecified nerve at shoulder and upper arm level, right arm, sequela
S44.92XA Injury of unspecified nerve at shoulder and upper arm level, left arm, initial encounter
S44.92XD Injury of unspecified nerve at shoulder and upper arm level, left arm, subsequent encounter
S44.92XS Injury of unspecified nerve at shoulder and upper arm level, left arm, sequela
S54.00XA Injury of ulnar nerve at forearm level, unspecified arm, initial encounter
S54.00XD Injury of ulnar nerve at forearm level, unspecified arm, subsequent encounter
S54.00XS Injury of ulnar nerve at forearm level, unspecified arm, sequela
S54.01XA Injury of ulnar nerve at forearm level, right arm, initial encounter
S54.01XD Injury of ulnar nerve at forearm level, right arm, subsequent encounter
S54.01XS Injury of ulnar nerve at forearm level, right arm, sequela
S54.02XA Injury of ulnar nerve at forearm level, left arm, initial encounter
S54.02XD Injury of ulnar nerve at forearm level, left arm, subsequent encounter
S54.02XS Injury of ulnar nerve at forearm level, left arm, sequela
S54.10XA Injury of median nerve at forearm level, unspecified arm, initial encounter
S54.10XD Injury of median nerve at forearm level, unspecified arm, subsequent encounter
S54.10XS Injury of median nerve at forearm level, unspecified arm, sequela
S54.11XA Injury of median nerve at forearm level, right arm, initial encounter
S54.11XD Injury of median nerve at forearm level, right arm, subsequent encounter
S54.11XS Injury of median nerve at forearm level, right arm, sequela
S54.12XA Injury of median nerve at forearm level, left arm, initial encounter
S54.12XD Injury of median nerve at forearm level, left arm, subsequent encounter
S54.12XS Injury of median nerve at forearm level, left arm, sequela
S54.20XA Injury of radial nerve at forearm level, unspecified arm, initial encounter
S54.20XD Injury of radial nerve at forearm level, unspecified arm, subsequent encounter
S54.20XS Injury of radial nerve at forearm level, unspecified arm, sequela
S54.21XA Injury of radial nerve at forearm level, right arm, initial encounter
S54.21XD Injury of radial nerve at forearm level, right arm, subsequent encounter
S54.21XS Injury of radial nerve at forearm level, right arm, sequela
S54.22XA Injury of radial nerve at forearm level, left arm, initial encounter
S54.22XD Injury of radial nerve at forearm level, left arm, subsequent encounter
S54.22XS Injury of radial nerve at forearm level, left arm, sequela
S54.30XA Injury of cutaneous sensory nerve at forearm level, unspecified arm, initial encounter
S54.30XD Injury of cutaneous sensory nerve at forearm level, unspecified arm, subsequent encounter
S54.30XS Injury of cutaneous sensory nerve at forearm level, unspecified arm, sequela
S54.31XA Injury of cutaneous sensory nerve at forearm level, right arm, initial encounter
S54.31XD Injury of cutaneous sensory nerve at forearm level, right arm, subsequent encounter
S54.31XS Injury of cutaneous sensory nerve at forearm level, right arm, sequela
S54.32XA Injury of cutaneous sensory nerve at forearm level, left arm, initial encounter
S54.32XD Injury of cutaneous sensory nerve at forearm level, left arm, subsequent encounter
S54.32XS Injury of cutaneous sensory nerve at forearm level, left arm, sequela
S54.8X1A Injury of other nerves at forearm level, right arm, initial encounter
S54.8X1D Injury of other nerves at forearm level, right arm, subsequent encounter
S54.8X1S Injury of other nerves at forearm level, right arm, sequela
S54.8X2A Injury of other nerves at forearm level, left arm, initial encounter
S54.8X2D Injury of other nerves at forearm level, left arm, subsequent encounter
S54.8X2S Injury of other nerves at forearm level, left arm, sequela
S54.8X9A Injury of other nerves at forearm level, unspecified arm, initial encounter
S54.8X9D Injury of other nerves at forearm level, unspecified arm, subsequent encounter
S54.8X9S Injury of other nerves at forearm level, unspecified arm, sequela
S54.90XA Injury of unspecified nerve at forearm level, unspecified arm, initial encounter
S54.90XD Injury of unspecified nerve at forearm level, unspecified arm, subsequent encounter
S54.90XS Injury of unspecified nerve at forearm level, unspecified arm, sequela
S54.91XA Injury of unspecified nerve at forearm level, right arm, initial encounter
S54.91XD Injury of unspecified nerve at forearm level, right arm, subsequent encounter
S54.91XS Injury of unspecified nerve at forearm level, right arm, sequela
S54.92XA Injury of unspecified nerve at forearm level, left arm, initial encounter
S54.92XD Injury of unspecified nerve at forearm level, left arm, subsequent encounter
S54.92XS Injury of unspecified nerve at forearm level, left arm, sequela
S64.00XA Injury of ulnar nerve at wrist and hand level of unspecified arm, initial encounter
S64.00XD Injury of ulnar nerve at wrist and hand level of unspecified arm, subsequent encounter
S64.00XS Injury of ulnar nerve at wrist and hand level of unspecified arm, sequela
S64.01XA Injury of ulnar nerve at wrist and hand level of right arm, initial encounter
S64.01XD Injury of ulnar nerve at wrist and hand level of right arm, subsequent encounter
S64.01XS Injury of ulnar nerve at wrist and hand level of right arm, sequela
S64.02XA Injury of ulnar nerve at wrist and hand level of left arm, initial encounter
S64.02XD Injury of ulnar nerve at wrist and hand level of left arm, subsequent encounter
S64.02XS Injury of ulnar nerve at wrist and hand level of left arm, sequela
S64.10XA Injury of median nerve at wrist and hand level of unspecified arm, initial encounter
S64.10XD Injury of median nerve at wrist and hand level of unspecified arm, subsequent encounter
S64.10XS Injury of median nerve at wrist and hand level of unspecified arm, sequela
S64.11XA Injury of median nerve at wrist and hand level of right arm, initial encounter
S64.11XD Injury of median nerve at wrist and hand level of right arm, subsequent encounter
S64.11XS Injury of median nerve at wrist and hand level of right arm, sequela
S64.12XA Injury of median nerve at wrist and hand level of left arm, initial encounter
S64.12XD Injury of median nerve at wrist and hand level of left arm, subsequent encounter
S64.12XS Injury of median nerve at wrist and hand level of left arm, sequela
S64.20XA Injury of radial nerve at wrist and hand level of unspecified arm, initial encounter
S64.20XD Injury of radial nerve at wrist and hand level of unspecified arm, subsequent encounter
S64.20XS Injury of radial nerve at wrist and hand level of unspecified arm, sequela
S64.21XA Injury of radial nerve at wrist and hand level of right arm, initial encounter
S64.21XD Injury of radial nerve at wrist and hand level of right arm, subsequent encounter
S64.21XS Injury of radial nerve at wrist and hand level of right arm, sequela
S64.22XA Injury of radial nerve at wrist and hand level of left arm, initial encounter
S64.22XD Injury of radial nerve at wrist and hand level of left arm, subsequent encounter
S64.22XS Injury of radial nerve at wrist and hand level of left arm, sequela
S64.30XA Injury of digital nerve of unspecified thumb, initial encounter
S64.30XD Injury of digital nerve of unspecified thumb, subsequent encounter
S64.30XS Injury of digital nerve of unspecified thumb, sequela
S64.31XA Injury of digital nerve of right thumb, initial encounter
S64.31XD Injury of digital nerve of right thumb, subsequent encounter
S64.31XS Injury of digital nerve of right thumb, sequela
S64.32XA Injury of digital nerve of left thumb, initial encounter
S64.32XD Injury of digital nerve of left thumb, subsequent encounter
S64.32XS Injury of digital nerve of left thumb, sequela
S64.40XA Injury of digital nerve of unspecified finger, initial encounter
S64.40XD Injury of digital nerve of unspecified finger, subsequent encounter
S64.40XS Injury of digital nerve of unspecified finger, sequela
S64.490A Injury of digital nerve of right index finger, initial encounter
S64.490D Injury of digital nerve of right index finger, subsequent encounter
S64.490S Injury of digital nerve of right index finger, sequela
S64.491A Injury of digital nerve of left index finger, initial encounter
S64.491D Injury of digital nerve of left index finger, subsequent encounter
S64.491S Injury of digital nerve of left index finger, sequela
S64.492A Injury of digital nerve of right middle finger, initial encounter
S64.492D Injury of digital nerve of right middle finger, subsequent encounter
S64.492S Injury of digital nerve of right middle finger, sequela
S64.493A Injury of digital nerve of left middle finger, initial encounter
S64.493D Injury of digital nerve of left middle finger, subsequent encounter
S64.493S Injury of digital nerve of left middle finger, sequela
S64.494A Injury of digital nerve of right ring finger, initial encounter
S64.494D Injury of digital nerve of right ring finger, subsequent encounter
S64.494S Injury of digital nerve of right ring finger, sequela
S64.495A Injury of digital nerve of left ring finger, initial encounter
S64.495D Injury of digital nerve of left ring finger, subsequent encounter
S64.495S Injury of digital nerve of left ring finger, sequela
S64.496A Injury of digital nerve of right little finger, initial encounter
S64.496D Injury of digital nerve of right little finger, subsequent encounter
S64.496S Injury of digital nerve of right little finger, sequela
S64.497A Injury of digital nerve of left little finger, initial encounter
S64.497D Injury of digital nerve of left little finger, subsequent encounter
S64.497S Injury of digital nerve of left little finger, sequela
S64.498A Injury of digital nerve of other finger, initial encounter
S64.498D Injury of digital nerve of other finger, subsequent encounter
S64.498S Injury of digital nerve of other finger, sequela
S64.8X1A Injury of other nerves at wrist and hand level of right arm, initial encounter
S64.8X1D Injury of other nerves at wrist and hand level of right arm, subsequent encounter
S64.8X1S Injury of other nerves at wrist and hand level of right arm, sequela
S64.8X2A Injury of other nerves at wrist and hand level of left arm, initial encounter
S64.8X2D Injury of other nerves at wrist and hand level of left arm, subsequent encounter
S64.8X2S Injury of other nerves at wrist and hand level of left arm, sequela
S64.8X9A Injury of other nerves at wrist and hand level of unspecified arm, initial encounter
S64.8X9D Injury of other nerves at wrist and hand level of unspecified arm, subsequent encounter
S64.8X9S Injury of other nerves at wrist and hand level of unspecified arm, sequela
S64.90XA Injury of unspecified nerve at wrist and hand level of unspecified arm, initial encounter
S64.90XD Injury of unspecified nerve at wrist and hand level of unspecified arm, subsequent encounter
S64.90XS Injury of unspecified nerve at wrist and hand level of unspecified arm, sequela
S64.91XA Injury of unspecified nerve at wrist and hand level of right arm, initial encounter
S64.91XD Injury of unspecified nerve at wrist and hand level of right arm, subsequent encounter
S64.91XS Injury of unspecified nerve at wrist and hand level of right arm, sequela
S64.92XA Injury of unspecified nerve at wrist and hand level of left arm, initial encounter
S64.92XD Injury of unspecified nerve at wrist and hand level of left arm, subsequent encounter
S64.92XS Injury of unspecified nerve at wrist and hand level of left arm, sequela
S74.00XA Injury of sciatic nerve at hip and thigh level, unspecified leg, initial encounter
S74.00XD Injury of sciatic nerve at hip and thigh level, unspecified leg, subsequent encounter
S74.00XS Injury of sciatic nerve at hip and thigh level, unspecified leg, sequela
S74.01XA Injury of sciatic nerve at hip and thigh level, right leg, initial encounter
S74.01XD Injury of sciatic nerve at hip and thigh level, right leg, subsequent encounter
S74.01XS Injury of sciatic nerve at hip and thigh level, right leg, sequela
S74.02XA Injury of sciatic nerve at hip and thigh level, left leg, initial encounter
S74.02XD Injury of sciatic nerve at hip and thigh level, left leg, subsequent encounter
S74.02XS Injury of sciatic nerve at hip and thigh level, left leg, sequela
S74.10XA Injury of femoral nerve at hip and thigh level, unspecified leg, initial encounter
S74.10XD Injury of femoral nerve at hip and thigh level, unspecified leg, subsequent encounter
S74.10XS Injury of femoral nerve at hip and thigh level, unspecified leg, sequela
S74.11XA Injury of femoral nerve at hip and thigh level, right leg, initial encounter
S74.11XD Injury of femoral nerve at hip and thigh level, right leg, subsequent encounter
S74.11XS Injury of femoral nerve at hip and thigh level, right leg, sequela
S74.12XA Injury of femoral nerve at hip and thigh level, left leg, initial encounter
S74.12XD Injury of femoral nerve at hip and thigh level, left leg, subsequent encounter
S74.12XS Injury of femoral nerve at hip and thigh level, left leg, sequela
S74.20XA Injury of cutaneous sensory nerve at hip and thigh level, unspecified leg, initial encounter
S74.20XD Injury of cutaneous sensory nerve at hip and thigh level, unspecified leg, subsequent encounter
S74.20XS Injury of cutaneous sensory nerve at hip and thigh level, unspecified leg, sequela
S74.21XA Injury of cutaneous sensory nerve at hip and high level, right leg, initial encounter
S74.21XD Injury of cutaneous sensory nerve at hip and high level, right leg, subsequent encounter
S74.21XS Injury of cutaneous sensory nerve at hip and high level, right leg, sequela
S74.22XA Injury of cutaneous sensory nerve at hip and thigh level, left leg, initial encounter
S74.22XD Injury of cutaneous sensory nerve at hip and thigh level, left leg, subsequent encounter
S74.22XS Injury of cutaneous sensory nerve at hip and thigh level, left leg, sequela
S74.8X1A Injury of other nerves at hip and thigh level, right leg, initial encounter
S74.8X1D Injury of other nerves at hip and thigh level, right leg, subsequent encounter
S74.8X1S Injury of other nerves at hip and thigh level, right leg, sequela
S74.8X2A Injury of other nerves at hip and thigh level, left leg, initial encounter
S74.8X2D Injury of other nerves at hip and thigh level, left leg, subsequent encounter
S74.8X2S Injury of other nerves at hip and thigh level, left leg, sequela
S74.8X9A Injury of other nerves at hip and thigh level, unspecified leg, initial encounter
S74.8X9D Injury of other nerves at hip and thigh level, unspecified leg, subsequent encounter
S74.8X9S Injury of other nerves at hip and thigh level, unspecified leg, sequela
S74.90XA Injury of unspecified nerve at hip and thigh level, unspecified leg, initial encounter
S74.90XD Injury of unspecified nerve at hip and thigh level, unspecified leg, subsequent encounter
S74.90XS Injury of unspecified nerve at hip and thigh level, unspecified leg, sequela
S74.91XA Injury of unspecified nerve at hip and thigh level, right leg, initial encounter
S74.91XD Injury of unspecified nerve at hip and thigh level, right leg, subsequent encounter
S74.91XS Injury of unspecified nerve at hip and thigh level, right leg, sequela
S74.92XA Injury of unspecified nerve at hip and thigh level, left leg, initial encounter
S74.92XD Injury of unspecified nerve at hip and thigh level, left leg, subsequent encounter
S74.92XS Injury of unspecified nerve at hip and thigh level, left leg, sequela
S84.00XA Injury of tibial nerve at lower leg level, unspecified leg, initial encounter
S84.00XD Injury of tibial nerve at lower leg level, unspecified leg, subsequent encounter
S84.00XS Injury of tibial nerve at lower leg level, unspecified leg, sequela
S84.01XA Injury of tibial nerve at lower leg level, right leg, initial encounter
S84.01XD Injury of tibial nerve at lower leg level, right leg, subsequent encounter
S84.01XS Injury of tibial nerve at lower leg level, right leg, sequela
S84.02XA Injury of tibial nerve at lower leg level, left leg, initial encounter
S84.02XD Injury of tibial nerve at lower leg level, left leg, subsequent encounter
S84.02XS Injury of tibial nerve at lower leg level, left leg, sequela
S84.10XA Injury of peroneal nerve at lower leg level, unspecified leg, initial encounter
S84.10XD Injury of peroneal nerve at lower leg level, unspecified leg, subsequent encounter
S84.10XS Injury of peroneal nerve at lower leg level, unspecified leg, sequela
S84.11XA Injury of peroneal nerve at lower leg level, right leg, initial encounter
S84.11XD Injury of peroneal nerve at lower leg level, right leg, subsequent encounter
S84.11XS Injury of peroneal nerve at lower leg level, right leg, sequela
S84.12XA Injury of peroneal nerve at lower leg level, left leg, initial encounter
S84.12XD Injury of peroneal nerve at lower leg level, left leg, subsequent encounter
S84.12XS Injury of peroneal nerve at lower leg level, left leg, sequela
S84.20XA Injury of cutaneous sensory nerve at lower leg level, unspecified leg, initial encounter
S84.20XD Injury of cutaneous sensory nerve at lower leg level, unspecified leg, subsequent encounter
S84.20XS Injury of cutaneous sensory nerve at lower leg level, unspecified leg, sequela
S84.21XA Injury of cutaneous sensory nerve at lower leg level, right leg, initial encounter
S84.21XD Injury of cutaneous sensory nerve at lower leg level, right leg, subsequent encounter
S84.21XS Injury of cutaneous sensory nerve at lower leg level, right leg, sequela
S84.22XA Injury of cutaneous sensory nerve at lower leg level, left leg, initial encounter
S84.22XD Injury of cutaneous sensory nerve at lower leg level, left leg, subsequent encounter
S84.22XS Injury of cutaneous sensory nerve at lower leg level, left leg, sequela
S84.801A Injury of other nerves at lower leg level, right leg, initial encounter
S84.801D Injury of other nerves at lower leg level, right leg, subsequent encounter
S84.801S Injury of other nerves at lower leg level, right leg, sequela
S84.802A Injury of other nerves at lower leg level, left leg, initial encounter
S84.802D Injury of other nerves at lower leg level, left leg, subsequent encounter
S84.802S Injury of other nerves at lower leg level, left leg, sequela
S84.809A Injury of other nerves at lower leg level, unspecified leg, initial encounter
S84.809D Injury of other nerves at lower leg level, unspecified leg, subsequent encounter
S84.809S Injury of other nerves at lower leg level, unspecified leg, sequela
S84.90XA Injury of unspecified nerve at lower leg level, unspecified leg, initial encounter
S84.90XD Injury of unspecified nerve at lower leg level, unspecified leg, subsequent encounter
S84.90XS Injury of unspecified nerve at lower leg level, unspecified leg, sequela
S84.91XA Injury of unspecified nerve at lower leg level, right leg, initial encounter
S84.91XD Injury of unspecified nerve at lower leg level, right leg, subsequent encounter
S84.91XS Injury of unspecified nerve at lower leg level, right leg, sequela
S84.92XA Injury of unspecified nerve at lower leg level, left leg, initial encounter
S84.92XD Injury of unspecified nerve at lower leg level, left leg, subsequent encounter
S84.92XS Injury of unspecified nerve at lower leg level, left leg, sequela
S94.00XA Injury of lateral plantar nerve, unspecified leg, initial encounter
S94.00XD Injury of lateral plantar nerve, unspecified leg, subsequent encounter
S94.00XS Injury of lateral plantar nerve, unspecified leg, sequela
S94.01XA Injury of lateral plantar nerve, right leg, initial encounter
S94.01XD Injury of lateral plantar nerve, right leg, subsequent encounter
S94.01XS Injury of lateral plantar nerve, right leg, sequela
S94.02XA Injury of lateral plantar nerve, left leg, initial encounter
S94.02XD Injury of lateral plantar nerve, left leg, subsequent encounter
S94.02XS Injury of lateral plantar nerve, left leg, sequela
S94.10XA Injury of medial plantar nerve, unspecified leg, initial encounter
S94.10XD Injury of medial plantar nerve, unspecified leg, subsequent encounter
S94.10XS Injury of medial plantar nerve, unspecified leg, sequela
S94.11XA Injury of medial plantar nerve, right leg, initial encounter
S94.11XD Injury of medial plantar nerve, right leg, subsequent encounter
S94.11XS Injury of medial plantar nerve, right leg, sequela
S94.12XA Injury of medial plantar nerve, left leg, initial encounter
S94.12XD Injury of medial plantar nerve, left leg, subsequent encounter
S94.12XS Injury of medial plantar nerve, left leg, sequela
S94.20XA Injury of deep peroneal nerve at ankle and foot level, unspecified leg, initial encounter
S94.20XD Injury of deep peroneal nerve at ankle and foot level, unspecified leg, subsequent encounter
S94.20XS Injury of deep peroneal nerve at ankle and foot level, unspecified leg, sequela
S94.21XA Injury of deep peroneal nerve at ankle and foot level, right leg, initial encounter
S94.21XD Injury of deep peroneal nerve at ankle and foot level, right leg, subsequent encounter
S94.21XS Injury of deep peroneal nerve at ankle and foot level, right leg, sequela
S94.22XA Injury of deep peroneal nerve at ankle and foot level, left leg, initial encounter
S94.22XD Injury of deep peroneal nerve at ankle and foot level, left leg, subsequent encounter
S94.22XS Injury of deep peroneal nerve at ankle and foot level, left leg, sequela
S94.30XA Injury of cutaneous sensory nerve at ankle and foot level, unspecified leg, initial encounter
S94.30XD Injury of cutaneous sensory nerve at ankle and foot level, unspecified leg, subsequent encounter
S94.30XS Injury of cutaneous sensory nerve at ankle and foot level, unspecified leg, sequela
S94.31XA Injury of cutaneous sensory nerve at ankle and foot level, right leg, initial encounter
S94.31XD Injury of cutaneous sensory nerve at ankle and foot level, right leg, subsequent encounter
S94.31XS Injury of cutaneous sensory nerve at ankle and foot level, right leg, sequela
S94.32XA Injury of cutaneous sensory nerve at ankle and foot level, left leg, initial encounter
S94.32XD Injury of cutaneous sensory nerve at ankle and foot level, left leg, subsequent encounter
S94.32XS Injury of cutaneous sensory nerve at ankle and foot level, left leg, sequela
S94.8X1A Injury of other nerves at ankle and foot level, right leg, initial encounter
S94.8X1D Injury of other nerves at ankle and foot level, right leg, subsequent encounter
S94.8X1S Injury of other nerves at ankle and foot level, right leg, sequela
S94.8X2A Injury of other nerves at ankle and foot level, left leg, initial encounter
S94.8X2D Injury of other nerves at ankle and foot level, left leg, subsequent encounter
S94.8X2S Injury of other nerves at ankle and foot level, left leg, sequela
S94.8X9A Injury of other nerves at ankle and foot level, unspecified leg, initial encounter
S94.8X9D Injury of other nerves at ankle and foot level, unspecified leg, subsequent encounter
S94.8X9S Injury of other nerves at ankle and foot level, unspecified leg, sequela
S94.90XA Injury of unspecified nerve at ankle and foot level, unspecified leg, initial encounter
S94.90XD Injury of unspecified nerve at ankle and foot level, unspecified leg, subsequent encounter
S94.90XS Injury of unspecified nerve at ankle and foot level, unspecified leg, sequela
S94.91XA Injury of unspecified nerve at ankle and foot level, right leg, initial encounter
S94.91XD Injury of unspecified nerve at ankle and foot level, right leg, subsequent encounter
S94.91XS Injury of unspecified nerve at ankle and foot level, right leg, sequela
S94.92XA Injury of unspecified nerve at ankle and foot level, left leg, initial encounter
S94.92XD Injury of unspecified nerve at ankle and foot level, left leg, subsequent encounter
S94.92XS Injury of unspecified nerve at ankle and foot level, left leg, sequela
Z48.3 Aftercare following surgery for neoplasm
Z48.89 Encounter for other specified surgical aftercare
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ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

Group 1 Paragraph

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Group 1 Codes

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ICD-10-PCS Codes

Group 1

Group 1 Paragraph

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Group 1 Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description

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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Code Description

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Other Coding Information

Group 1

Group 1 Paragraph

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Group 1 Codes

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
05/25/2023 R7

Under CMS National Coverage Policy updated section headings for regulations. Formatting was corrected throughout the article.

01/01/2023 R6

Under CPT/HCPCS Codes Group 1: Codes the description was revised for 64416, 64446 and 64448. This revision is due to the 2023 Annual/Q1 CPT/HCPCS Code Update and is retroactive effective for dates of service on or after 1/1/23.

10/01/2021 R5

Under ICD-10 Codes that Support Medical Necessity Group 1: Codes added M54.50, M54.51 and M54.59. This revision is due to the Annual ICD-10 Update and will become effective on 10/1/2021.

10/01/2020 R4

Under ICD-10 Codes that Support Medical Necessity Group 1: Codes added M25.59. This revision is due to the Annual ICD-10 Code Update and is effective on October 1, 2020.

01/01/2020 R3

Under CPT/HCPCS Codes Group 1: Codes the code descriptions were revised for CPT® codes 64416, 64446, 64448, and 64449. This revision is due to the Annual CPT®/HCPCS Code Update and becomes effective on 1/1/2020.

10/10/2019 R2

This article is being revised in order to adhere to CMS requirements per Chapter 13, Section 13.5.1 of the Program Integrity Manual, to remove all coding from LCDs and incorporate into related Billing and Coding Articles. Regulations regarding billing and coding were removed from the CMS National Coverage Policy section of the related Continuous Peripheral Nerve Blocks (CPNB) L37641 LCD and placed in this article.

06/06/2019 R1

All coding located in the Coding Information section has been removed from the related Continuous Peripheral Nerve Blocks (CPNB) L37641 LCD and added to this article.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L37641 - Continuous Peripheral Nerve Blocks (CPNB)
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Other URLs
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Public Versions
Updated On Effective Dates Status
05/16/2023 05/25/2023 - N/A Currently in Effect You are here
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

  • Continuous Peripheral
  • Nerve Blocks
  • CPNB