Summary & Overview
CPT 64415: Brachial Plexus Nerve Block Injection
CPT code 64415 denotes injection(s) of anesthetic and/or steroid into the brachial plexus for regional anesthesia or therapeutic nerve blockade of the upper extremity. This procedure is clinically important for perioperative pain control, chronic pain management, and diagnostic nerve blockade. Nationally, accurate coding of 64415 affects procedural reporting, payment determination, and quality tracking for nerve block services. Key public and commercial payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise framing of the clinical procedure and site-of-service considerations, an outline of common billing modifiers used with nerve block services, and an overview of payer coverage patterns and coding guidance where available. The publication also highlights typical settings where the service is delivered and practical coding notes that influence claims adjudication. Data not available in the input will be explicitly noted in relevant sections. The content is intended to help coding managers, billing staff, and policy analysts understand the clinical context and payer landscape for CPT code 64415 at a national level.
Billing Code Overview
CPT code 64415 describes injection(s) of one or more anesthetic agents and/or a steroid into the brachial plexus area, a network of nerves that supplies the arm and originates in the neck. The code is reported for a single procedure during which one or more injections to the brachial plexus are performed.
Service type: Nerve block / regional anesthetic injection
Typical site of service: Ambulatory surgical centers, hospital outpatient departments, and office-based procedure settings
Clinical & Coding Specifications
Clinical Context
A 52-year-old right-handed patient presents to an outpatient interventional pain clinic with 3 months of progressive, severe left upper extremity radicular pain, numbness, and paresthesia radiating from the neck into the shoulder and lateral forearm. Conservative therapies including physical therapy, nonsteroidal anti-inflammatory drugs, and a short course of oral corticosteroids provided insufficient relief. Imaging (cervical spine MRI) shows left C6–C7 foraminal narrowing consistent with radiculopathy. The interventional pain physician schedules a left interscalene/brachial plexus injection to deliver a local anesthetic and steroid to target the brachial plexus for diagnostic and therapeutic benefit.
The clinical workflow: the patient arrives to an ambulatory procedure suite or outpatient surgery center. Pre-procedure assessment confirms indications, allergies, medications, and informed consent. Ultrasound and/or fluoroscopic guidance is used to identify the brachial plexus. The provider injects one or more anesthetic agents and/or steroid(s) around the brachial plexus in a single procedure, documents laterality, drugs and volumes, informed consent, vital signs, and post-procedure discharge instructions. Post-injection pain and neurologic response are assessed to determine diagnostic information and need for further treatment such as repeat injection, physical therapy, or referral for surgical consultation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side |