As the healthcare landscape continues to evolve, staying ahead of anesthesia coding updates is critical for anesthesia practices. In 2025, new fascial plane block codes will streamline the reporting process, reducing reliance on unlisted procedure codes like 64999 and paving the way for faster and more consistent reimbursements. These updates not only simplify billing but also address common pain points like claim denials and appeals. Additionally, the integration of imaging guidance into these codes reflects ongoing efforts to improve efficiency and accuracy in coding practices. Here’s a closer look at what anesthesia providers need to know about these changes, including tips for compliance and documentation best practices.
Currently we are reporting several pain blocks with the unlisted procedure code of 64999. In December 2022, CPT Assistant came out with guidance that planar blocks without their own specific CPT codes (such as TAP blocks) are to be reported with 64999. These include PEC blocks, Serratus Anterior Plane blocks, Erector Spinae blocks, iPACK blocks, Fascial Iliaca blocks, Quadratus Lumborum blocks, and PENG blocks just to name a few.
For 2025 there will be new fascial plane block codes that will greatly reduce the number of blocks we currently are reporting with 64999, making the reimbursement for these services prompt and consistent without having to jump through all the hoops associated with reporting unlisted procedure codes.
In keeping with the creation of new pain block codes, as well as the changes to the most common pain block codes associated with post-operative pain management, CPT has bundled imaging guidance into these new codes.
New fascial plane block codes should greatly reduce the number of claim denials associated with reporting unlisted procedure codes, thereby reducing the time it takes a payer to process claims, and the work involved in the appeal process that should not be required with the new codes.
Just a reminder that post-operative pain management services are included (bundled) in the surgeon’s global fee for the procedure. The Medicare NCCI (National Correct Coding Initiative) Policy Manual, Chapter 2 states that the surgeon is responsible for documenting in the medical record the reason that care is being referred to the anesthesia practitioner. Historically, anesthesia providers have documented this request within their procedure notes, but there is chatter among industry experts that payers are starting to look for this information documented by the surgeon within the medical record. Best practice documentation is to make sure that the surgeon is also documenting this request in case this information is needed in the event of an audit or post-payment review.
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