Ask Dr. Z

Ethanol nerve block was performed, but my colleague and I are debating whether or not code 64680 or 64530 should be reported. See report that follows: "Under CT guidance, a 22 gauge Chiba needle was advanced to the celiac ganglion bilaterally from a left and right paraspinal approach, respectively. With the target celiac ganglion at the tip of the Chiba needle, the stylet was removed and monitored for any blood draw back to assure the needle tip was not within a vascular structure. Very dilute contrast was injected to evaluate placement of the needle tip and to again assure the needle tip was not within a vascular structure. Approximately 15 mL of 95% ethanol mixed with approximately 5 mL of 0.5% bupivacaine and 3 mL of Isovue 370 was hand injected to the celiac ganglion bilaterally at a rate of approximately 0.5 mL per second while under intermittent fluoroscopic CT guidance." Would this be coded as a nerve block or nerve destruction?