Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot
Code deleted, to report see 64999

Official Description

Injection, anesthetic agent; spinal accessory nerve

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 64412 involves the injection of an anesthetic agent into the spinal accessory nerve, which is also known as cranial nerve XI (CN XI). This nerve plays a crucial role in innervating the trapezius muscle and the posterior triangle of the neck, making it significant in both diagnostic and therapeutic contexts. The injection, commonly referred to as a nerve block, can be utilized to alleviate pain or discomfort associated with conditions affecting the trapezius muscle or surrounding areas. The spinal accessory nerve exits the skull through the jugular foramen and traverses the upper and middle thirds of the sternocleidomastoid muscle, which is a key landmark during the procedure. Prior to the injection, the skin over the junction of the upper and middle thirds of the sternocleidomastoid muscle is thoroughly cleansed to minimize the risk of infection. The posterior border of the sternocleidomastoid muscle is then identified, and a needle is carefully inserted to deliver the anesthetic agent directly into the spinal accessory nerve, providing targeted relief for the patient.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The injection of an anesthetic agent into the spinal accessory nerve is indicated for various conditions that may cause pain or discomfort in the areas innervated by this nerve. The following are explicitly provided indications for this procedure:

  • Pain Management - This procedure is often performed to manage pain associated with conditions affecting the trapezius muscle or the posterior triangle of the neck.
  • Diagnostic Evaluation - The injection may also serve as a diagnostic tool to determine the source of pain or discomfort in the neck and shoulder region.

2. Procedure

The procedure for injecting an anesthetic agent into the spinal accessory nerve involves several key steps that ensure accuracy and safety. Each step is critical for the successful administration of the nerve block.

  • Step 1: Preparation - The skin over the junction of the upper and middle thirds of the sternocleidomastoid muscle is cleansed thoroughly to reduce the risk of infection. This step is essential for maintaining a sterile environment during the procedure.
  • Step 2: Identification of Anatomical Landmarks - The posterior border of the sternocleidomastoid muscle is located. This anatomical landmark is crucial for guiding the needle insertion and ensuring that the anesthetic agent is delivered accurately to the spinal accessory nerve.
  • Step 3: Needle Insertion - A needle is carefully inserted at the identified location. The technique requires precision to avoid injury to surrounding structures while ensuring that the anesthetic agent reaches the target nerve.
  • Step 4: Injection of Anesthetic Agent - Once the needle is in the correct position, the anesthetic agent is injected into the spinal accessory nerve. This step is aimed at providing immediate relief from pain or discomfort associated with the conditions being treated.

3. Post-Procedure

After the injection of the anesthetic agent into the spinal accessory nerve, patients may be monitored for any immediate adverse reactions. It is important to assess the effectiveness of the nerve block in alleviating pain. Patients may experience temporary numbness or weakness in the areas innervated by the spinal accessory nerve, which is expected. Post-procedure care may include advising the patient to avoid strenuous activities for a short period to allow for recovery. Additionally, follow-up appointments may be scheduled to evaluate the long-term effectiveness of the procedure and to determine if further treatment is necessary.

Short Descr N BLOCK INJ SPINAL ACCESSOR
Medium Descr INJECTION ANESTHETIC AGENT SPINAL ACCESSORY NRV
Long Descr Injection, anesthetic agent; spinal accessory 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) 1 - Statutory 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) P6C - Minor procedures - other (Medicare fee schedule)
MUE Not applicable/unspecified.
CCS Clinical Classification 5 - Insertion of catheter or spinal stimulator and injection into spinal canal
Date
Action
Notes
2016-01-01 Deleted Code deleted, to report see 64999
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"