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Coding/Pricing Update: Intercostal Nerve Injections

Horizon BCBSNJ is aligning our approach to CPT® code 64421 with the revised approach to intercostal nerve injection services determined by the American Medical Association (AMA) editorial board as part of their 2020 updates.1

For services provided on and after January 1, 2020, CPT code 64421 is considered an add-on code.

In 2019, the submission of a transaction/claim for intercostal nerve injection services would have included either CPT 64420 (a single nerve injection) or 64421 (multiple nerve injections). For 2020, the submission of a transaction/claim for intercostal nerve injection services, depending on the services provided, might include both 64420 and multiple units of 64421, as appropriate.

As part of this change in approach, Horizon BCBSNJ will change the allowance we will consider for 64421 for dates of service in 2020. We encourage you to review this fee information on NaviNet.net. Simply:

  • Select Horizon BCBSNJ from the My Health Plans menu.
  • Mouse over Claim Management and select Fee Schedule Inquiry.
  • On the Fee Schedule Inquiry page, select your Billing (Tax) ID Number, County and Specialty.
  • Enter the specific CPT and/or HCPCS codes to view our allowances for those specific services.

We will identify all 2020 claims that include 64421 that were processed prior to our February 1, 2020 pricing update to review and adjust as appropriate.

If you have questions, please contact your Network Specialist.

1 Information on new and updated CPT codes is available on the AMA website.

CPT® is a registered mark of the American Medical Association

Published on: February 4, 2020, 13:09 p.m. ET
Last updated on: February 4, 2020, 14:13 p.m. ET