Improvement
Nerve block claims: expanded ultrasound guidance list, cleaner add-on modifiers, and matching diagnoses on the guidance line
Work processed after carries this change.
GuidesDevelopersChangelog
Every release and every piece of in-flight work for Medical Auto Coding. Filter by status, kind, or tag, then read the full notes below.
| Status | Kind | What changed | Version | Ticket | Date |
|---|---|---|---|---|---|
| Released | Improvement | Nerve block claims: expanded ultrasound guidance list, cleaner add-on modifiers, and matching diagnoses on the guidance line | No version | No ticket | |
| Released | Fix | A documented procedure is no longer withheld when the note does not name the performer | No version | No ticket |
Work processed after carries this change.
Work processed after carries this change.
This release changes three things on anesthesia claims that include a peripheral nerve block. Our coding experts directed each change. No action is required on your side.
More blocks qualify for ultrasound guidance (76942). The autocoder now adds 76942 to the following block codes when the record documents ultrasound guidance and image storage: 64400, 64405, 64408, 64418, 64420, 64421, 64425, 64430, 64435, 64449, 64450, 64505, 64510, 64517, 64520, 64530, and 64999. New to the list are 64408 (vagus), 64421 (additional intercostal), 64430 (pudendal), 64435 (paracervical), 64505 (sphenopalatine), 64510 (stellate ganglion), 64517 (superior hypogastric), 64520 (lumbar or thoracic paravertebral sympathetic), and 64530 (celiac plexus). Code 64418 (suprascapular) stays on the list: an earlier version of this entry said it was removed, but our experts confirmed on 2026-08-15 that CPT does not bundle imaging into 64418, so 76942 stays billable with it when ultrasound and image storage are documented.
Add-on block lines no longer carry modifier 59 or the X modifiers. When a block is billed as a primary code plus an add-on code (for example, 64461 with 64462), the add-on line is already distinct by definition. The autocoder no longer places 59, XE, XS, XP, or XU on add-on lines. Primary lines are not affected.
The 76942 line now carries the same diagnoses as its nerve block. The ultrasound guidance line used to copy diagnoses from elsewhere on the claim. It now shows the diagnoses on the block line it supports, such as G89.18 (other acute postprocedural pain), and nothing else.
What to look out for: on claims with a suprascapular, pudendal, paracervical, stellate, celiac, hypogastric, or paravertebral sympathetic block, expect a 76942 line when ultrasound and image storage are documented. On claims with add-on block codes, expect the add-on line without 59 or an X modifier.
A missing provider name inside a procedure note no longer makes the procedure non billable. The autocoder was marking clearly documented procedures as non billable, with the reason "provider not documented", whenever the procedure section did not name the performer in line. That reason was never a valid rule. The autocoder resolves provider attribution later, so a missing name in one section is not a reason to withhold the code.
Flat fee procedures and neuraxial procedures are the ones you will notice. One case seen in production is a pre-operative combined spinal epidural catheter, code 62326. The procedure was documented, and the autocoder still marked it non billable. It bills now.
What to look out for: expect these procedures to appear as billable lines on notes where the performer is not named in the procedure section. Compare a few recent claims of this type against the record. When a procedure must not bill for a different reason, the autocoder still reports that reason.