CPT® Code 64416

Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed

The procedure described by CPT® Code 64416 involves the injection of anesthetic agents and/or steroids into the brachial plexus through a continuous infusion method. This procedure, commonly referred to as a nerve block, serves both diagnostic and therapeutic purposes. The brachial plexus is a network of nerves that originates from the spinal cord and extends into the arm, providing motor and sensory function. The injection is performed with the arm in an abducted position, the elbow flexed, and the hand elevated above the shoulder to facilitate access to the brachial plexus. Prior to the injection, the skin is thoroughly cleansed and anesthetized to minimize discomfort. A needle is then inserted into either the infraclavicular or supraclavicular region, and advanced carefully into the brachial plexus sheath. To ensure accurate placement, the needle's position is confirmed through electrical nerve stimulation or by observing the onset of sensory changes such as numbness or tingling. Imaging guidance, such as ultrasound, may also be utilized to enhance precision. Once the needle is correctly positioned, a cannula is threaded over the needle into the brachial plexus sheath, and the needle is subsequently removed. An epidural-type catheter is then introduced through the cannula to facilitate the continuous infusion of the anesthetic agent, which is typically a local anesthetic like lidocaine or bupivacaine. The effectiveness of the nerve block is assessed, and the continuous infusion is initiated to provide ongoing pain relief or anesthesia.