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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; cervical plexus

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The cervical plexus is a network of nerves formed by the anterior rami of the C1 to C4 spinal nerve roots. This plexus is situated anterior to the cervical spine and posterior to the sternocleidomastoid muscle, which is a prominent muscle in the neck. In the context of a cervical plexus block, the procedure involves the careful identification and marking of the posterior border of the sternocleidomastoid muscle, as well as the planned injection site(s). The procedure can be performed as a superficial cervical plexus block, where a single injection is typically administered at the midpoint of the sternocleidomastoid muscle, or as a deep cervical plexus block, which may require multiple injections between the C2 and C6 vertebrae. During the procedure, the clinician inserts a needle and performs aspiration to confirm that the needle is not positioned within a blood vessel or, in the case of a deep block, to ensure that it has not entered the subarachnoid space. Once proper placement is confirmed, the anesthetic agent is injected. If multiple injections are necessary, this process is repeated until the desired level of anesthesia or analgesia is achieved, providing effective pain management for various surgical or diagnostic procedures involving the neck and upper shoulder regions.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The cervical plexus block is indicated for various clinical scenarios where pain management is required in the neck and upper shoulder regions. The following conditions may warrant the use of this procedure:

  • Postoperative Pain Management This procedure is often utilized to manage pain following surgeries involving the neck, such as thyroidectomy or carotid endarterectomy.
  • Chronic Pain Conditions Patients suffering from chronic pain syndromes in the cervical region may benefit from this block to alleviate discomfort.
  • Diagnostic Procedures The cervical plexus block can be performed to facilitate certain diagnostic procedures by providing anesthesia to the targeted area.

2. Procedure

The procedure for administering a cervical plexus block involves several key steps to ensure accuracy and effectiveness. The following outlines the procedural steps:

  • Step 1: Identification of Anatomical Landmarks The clinician begins by identifying the posterior border of the sternocleidomastoid muscle in the neck. This muscle serves as a critical landmark for the injection site.
  • Step 2: Marking the Injection Site Once the sternocleidomastoid muscle is located, the clinician marks the planned injection site(s) on the skin to guide the needle placement.
  • Step 3: Needle Insertion For a superficial cervical plexus block, a single injection is typically administered at the midpoint of the sternocleidomastoid muscle. In contrast, for a deep cervical plexus block, multiple injections may be required between the C2 and C6 vertebrae. The needle is carefully inserted at the marked site.
  • Step 4: Aspiration After inserting the needle, the clinician performs aspiration to confirm that the needle is not within a blood vessel. In the case of a deep block, aspiration is also performed to ensure that the needle has not penetrated the subarachnoid space.
  • Step 5: Injection of Anesthetic Once proper needle placement is confirmed, the anesthetic agent is injected into the cervical plexus. If multiple injections are necessary, the clinician repeats the insertion and injection process until the desired level of anesthesia or analgesia is achieved.

3. Post-Procedure

After the cervical plexus block is performed, patients are typically monitored for any immediate adverse reactions to the anesthetic agent. It is important to assess the effectiveness of the block in providing pain relief. Patients may experience temporary numbness or weakness in the neck and shoulder area, which is expected. Post-procedure care may include advising patients on activity restrictions and monitoring for any signs of complications, such as hematoma or infection at the injection site. Follow-up appointments may be scheduled to evaluate the long-term effectiveness of the block and to determine if additional interventions are necessary.

Short Descr N BLOCK INJ CERVICAL PLEXUS
Medium Descr INJECTION ANESTHETIC AGENT CERVICAL PLEXUS
Long Descr Injection, anesthetic agent; cervical plexus
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 8 - Other non-OR or closed 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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