Summary & Overview
CPT 64466: Unilateral Thoracic Fascial Plane Block, Injection
CPT code 64466 represents a unilateral thoracic fascial plane block — a regional anesthesia procedure that delivers targeted pain relief to the chest wall and thoracic structures, and it includes imaging guidance when used. This code is relevant nationally as thoracic fascial plane blocks increasingly supplement systemic analgesia for acute postoperative and traumatic chest pain, influencing clinical pathways, perioperative protocols, and payment rules across multiple payers. Key payers evaluated include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise policy and billing overview, payer coverage patterns, common modifier usage, and clinical context explaining where and when the block is typically performed. The publication highlights benchmarks and payment considerations that affect provider billing and coding workflows, clarifies the service settings where 64466 is commonly submitted, and outlines documentation elements typically associated with regional thoracic block claims. Data not available in the input is noted where applicable. This resource is intended for billing staff, anesthesiologists, perioperative leaders, and compliance teams seeking a national-level understanding of CPT code 64466 and its practical implications.
Billing Code Overview
CPT code 64466 describes one or more injections for a unilateral thoracic fascial plane block, a regional anesthesia technique that provides pain relief in the chest wall and thoracic region. The code explicitly includes any imaging guidance when performed.
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Service type: Regional anesthesia / fascial plane block
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Typical site of service: Hospital inpatient, hospital outpatient department, ambulatory surgery center, or other procedural settings where regional nerve blocks are performed
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents to the ambulatory procedure suite for management of severe post-thoracotomy pain following a recent left-sided thoracotomy for lobectomy. The patient reports focal chest wall pain localized to the left lateral thorax and is receiving multimodal analgesia but requires an interventional procedure for additional pain control. After informed consent, the interventional pain physician or regional anesthesiologist reviews imaging, monitors vital signs, and positions the patient in a lateral decubitus or sitting position. Under sterile technique and using ultrasound or fluoroscopic imaging guidance, the clinician performs a unilateral thoracic fascial plane block with one or more injections of local anesthetic in the appropriate fascial plane to provide analgesia to the chest wall. The procedure typically occurs in an ambulatory surgery center, hospital operating room, or inpatient procedure room; post-procedure monitoring includes assessment of sensory block, hemodynamic stability, and discharge or transfer to the recovery area once criteria are met.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier used or standard billing | When no specific modifier applies; often unused in payer edits but listed in source data |
22 |