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Code deleted. To report injection of anesthetic agent and/or steroid to the phrenic nerve, cervical plexus, use 64999

Official Description

Injection, anesthetic agent; phrenic nerve

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 64410 involves the injection of an anesthetic agent into the phrenic nerve, which is a critical component of the respiratory system. The phrenic nerve is a mixed spinal nerve that originates from the cervical spinal roots, specifically from C4. Its primary function is to innervate the diaphragm, the muscle responsible for breathing, and it also carries sensory information from the pleura, lungs, and pericardium. This injection, commonly referred to as a nerve block, can be performed for both diagnostic and therapeutic purposes. In a diagnostic context, it may help determine the source of pain or dysfunction related to the diaphragm or associated structures. Therapeutically, it can provide relief from pain or discomfort caused by conditions affecting the diaphragm or surrounding areas. The procedure begins with the cleansing of the skin over the C4 region of the spine to minimize the risk of infection. A needle is then carefully inserted to reach the phrenic nerve, and aspiration is performed to confirm that the needle is not positioned within a blood vessel before the anesthetic agent is injected. This careful technique is essential to ensure the safety and efficacy of the procedure.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The injection of an anesthetic agent into the phrenic nerve, as described by CPT® Code 64410, is indicated for various clinical scenarios. The following conditions may warrant this procedure:

  • Diagnostic Evaluation - To assess the source of pain or dysfunction related to the diaphragm or associated structures.
  • Pain Management - To provide relief from pain caused by conditions affecting the diaphragm, pleura, or surrounding areas.
  • Respiratory Conditions - In cases where diaphragm function is compromised, leading to respiratory distress or discomfort.

2. Procedure

The procedure for the injection of an anesthetic agent into the phrenic nerve involves several critical steps to ensure accuracy and safety. The following procedural steps are outlined:

  • Step 1: Preparation - The skin over the C4 region of the spine is thoroughly cleansed using an antiseptic solution to reduce the risk of infection. This step is crucial for maintaining a sterile environment during the procedure.
  • Step 2: Needle Insertion - A needle is carefully inserted into the area where the phrenic nerve is located. The clinician must use anatomical landmarks and imaging guidance, if necessary, to accurately target the nerve.
  • Step 3: Aspiration - Once the needle is in position, aspiration is performed to ensure that the needle tip is not within a blood vessel. This step is vital to prevent complications such as hematoma formation or inadvertent intravascular injection.
  • Step 4: Injection of Anesthetic Agent - After confirming the correct placement of the needle, an anesthetic agent is injected into the phrenic nerve. This agent will block nerve transmission, providing pain relief or diagnostic information as needed.

3. Post-Procedure

Following the injection of the anesthetic agent into the phrenic nerve, patients may be monitored for any immediate adverse reactions or complications. It is important to observe the patient for signs of respiratory distress or any unusual symptoms. Patients may experience temporary relief from pain or discomfort, and the duration of this relief can vary based on individual factors and the specific anesthetic used. Instructions for post-procedure care should be provided, including recommendations for activity levels and signs to watch for that may require medical attention. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and to determine if further interventions are necessary.

Short Descr N BLOCK INJ PHRENIC
Medium Descr INJECTION ANESTHETIC AGENT PHRENIC NERVE
Long Descr Injection, anesthetic agent; phrenic nerve
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) 0 - 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 Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE Not applicable/unspecified.
CCS Clinical Classification 9 - Other OR therapeutic nervous system procedures
Date
Action
Notes
2019-12-31 Deleted Code deleted. To report injection of anesthetic agent and/or steroid to the phrenic nerve, cervical plexus, use 64999
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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