March 29, 2018

Question:
Can I report 19364 (breast reconstruction) and CPT 64421-59 (nerve block) on the same breast for post-operative pain management?  I have been submitted both to Medicare with Modifier 59 and have been receiving denials for 64421.

Answer:
CPT code 64421 for the injection of the anesthetic agent is included in the breast reconstruction procedures and cannot be reported separately.

*This response is based on the best information available as of 03/29/18.