CCSD code A7352 – Image-guided named major nerve or plexus block

Key takeaways

CCSD code A7352 covers image-guided local anaesthetic blockade of a named major nerve or plexus. Image guidance is part of the code, so the note must show it was used.

The same block without image guidance is A7350. A continuous block through an indwelling catheter is A7302, which is the code that carries the “as sole procedure” qualifier.

The named nerve or plexus must be identified in the operative note. A claim that cites “peripheral nerve” without naming it invites a query from the insurer.

Stellate ganglion and coeliac plexus blocks have their own CCSD codes (25022, 25100 and 25110), so they do not belong under A7352.

Practice management software like Pabau supports CCSD code lookup, pre-authorization tracking and claim submission for UK private practices.

CCSD code A7352: Definition and clinical scope

CCSD code A7352 is the procedure code for image-guided local anaesthetic blockade of a named major nerve or plexus. It sits in Chapter 3 of the CCSD schedule (“Spine, spinal cord and peripheral nerves”), under subsection 3.7, other nerve blocks, at minor complexity.

The code applies when a consultant anaesthetist or pain specialist injects local anaesthetic around a named nerve or plexus under ultrasound, fluoroscopic or CT guidance. The injection interrupts sensory, motor or autonomic transmission, either to confirm a diagnosis or to relieve pain.

Image guidance is written into the descriptor itself: Image-guided local anaesthetic blockade of named major nerve or plexus. Freedom Health Insurance (April 2026), the States of Guernsey surgical fee schedules and Aetna International all word A7352 this way. A block placed by landmark technique alone belongs under A7350 instead.

A7352 is used mainly in interventional pain management, for diagnostic and therapeutic blocks. Consultants moving from NHS work into private practice should note that NHS procedures are coded with OPCS-4. Those coding habits do not carry across to CCSD.

Which nerves and plexuses does A7352 cover?

“Named major” is the operative qualifier. The nerve or plexus must be anatomically specific and documented by its proper name in the procedure note. The following targets fit A7352 when the block is image-guided:

• Brachial plexus: upper limb and shoulder analgesia, by interscalene, supraclavicular, infraclavicular or axillary approach.
• Lumbar plexus: hip, thigh and anterior knee pain.
• Sciatic nerve: posterior lower limb blocks.
• Femoral nerve: anterior thigh and knee analgesia.
• Suprascapular nerve: chronic shoulder pain.
• Greater or lesser occipital nerve: occipital neuralgia and cervicogenic headache.

Some schedules name occipital, suprascapular, intercostal and trigeminal branch blocks inside the A7350 descriptor. When one of these is image-guided and documented as such, check which of the two codes the insurer expects.

Several blocks that look similar carry codes of their own. Stellate ganglion blocks use 25022 (local anaesthetic), and coeliac plexus blocks use 25100 (diagnostic) or 25110 (therapeutic). Nerve root blocks sit in the A5753 to A5756 range. Trigger point injections and field blocks target muscle or tissue rather than a named nerve, so they fall outside A7352.

A7352, A7350 or A7302: How image guidance and continuous blocks change the code

Most A7352 coding errors involve its two nearest neighbors in Chapter 3. All three cover local anaesthetic blocks of major nerves. Two facts decide between them: how the needle was placed, and how long the block runs.

• A7352: a single-shot local anaesthetic block of a named major nerve or plexus, placed under image guidance.
• A7350: the same kind of block without image guidance. Aetna International (2019) words it “Local anaesthetic blockade of named major nerve or plexus”.
• A7350, alternative wording: the Guernsey 2021 schedule describes blockade of a major nerve trunk, including occipital, sphenopalatine, trigeminal branch, intercostal and suprascapular blocks.
• A7302: “Continuous nerve block +/- image guidance (as sole procedure)”. A catheter delivers local anaesthetic over time, and this is the code that carries the sole-procedure qualifier.

A practical rule follows, set out as three questions in the diagram below. First confirm the target is a named major nerve or plexus. Then check whether a catheter was left in place, and finally look for image guidance and saved images.

• Correct use: a patient attends for an ultrasound-guided suprascapular nerve block for shoulder pain. The images are saved to the record. Bill A7352.
• Incorrect use: a greater occipital nerve block is placed by landmark technique, with no imaging. Billing A7352 overstates the procedure, so the claim belongs under A7350.
• Edge case: an ultrasound-guided brachial plexus catheter is placed for extended analgesia. The continuous element points to A7302, so confirm the insurer’s rules before adding A7352.

When a block forms part of the anaesthetic for surgery, many insurers pay it within the anaesthetist’s fee for that operation. Check the payer’s rules before adding A7352 to a surgical episode.

Image-guided nerve block CCSD billing: What the guidance requirement means for A7352

Because image guidance is inherent to A7352, the guidance record is the evidence the insurer checks. A claim coded A7352 with no record of imaging reads as an unguided block, which invites a query or a request to recode.

None of the schedules above lists a separate guidance code alongside A7352. Treat the imaging as included in the code, and add a guidance line only where the insurer’s own schedule allows one.

Related CCSD codes: How A7352 fits in Chapter 3

Selecting the correct code means knowing A7352’s neighbors. The table below lists the related codes billers most often confuse with it, taken from the Freedom Health Insurance, Guernsey and Aetna International schedules. Other procedures in the schedule are covered in our CCSD billing guides.

Descriptors and code sets differ between insurers and schedule editions, so check each payer’s current list before billing.

CCSD A7352 documentation requirements for insurer acceptance

Documentation quality is what separates a clean A7352 claim from a denial. UK private insurers expect the operative note to contain each of the items below. Digital clinical forms built for nerve block procedures cut omissions and speed up insurer review.

• Named nerve or plexus: the target documented by its proper clinical name, such as “right brachial plexus, interscalene approach”, not “nerve block, right shoulder”.
• Laterality: left, right or bilateral, clearly stated. Bilateral procedures may need a separate line item, depending on insurer policy.
• Approach or technique: the injection approach where more than one exists for the same nerve, such as posterior popliteal or anterior femoral.
• Image guidance: the modality (ultrasound, fluoroscopy or CT), confirmation that guidance was used during needle placement, and a note that images were saved. Without it, the claim does not meet the A7352 descriptor.
• Agent and volume: the local anaesthetic used, its concentration and the volume injected.
• Clinical indication: the diagnosis supporting the procedure, with a matching ICD-10 code on the claim form.
• Clinician credentials: confirmation that the performing clinician is recognized by the insurer as a specialist.
• Consent: documented patient consent for the specific procedure, including the use of image guidance.

Standardized procedure note templates, pre-populated with these fields, reduce retrospective insurer queries. One shared template also holds every clinician in the practice to the same documentation standard.

Payer requirements: Pre-authorization and insurer rules for A7352

Pre-authorization rules for A7352 vary between UK private insurers. The table below summarizes the position of four major payers, but policies change between contract cycles. Verify the current position with each insurer, and check the Bupa fee schedule for reimbursement ranges.

Tracking pre-authorization by hand adds administrative risk for practices managing several funding sources. Practice software with built-in pre-authorization workflows makes it less likely that a claim goes ahead without approval. A missing approval is one of the most preventable denial causes.

Common reasons A7352 nerve block claims are denied

Most A7352 denials trace back to the note or to code selection, which makes them predictable. Auditing claims before submission catches them while they are still cheap to fix.

• No evidence of image guidance: A7352 is billed, but the note does not confirm guidance or the saved images are missing. The code depends on guidance, so this is the most preventable error.
• Continuous block coded as single shot: a catheter was left in place for ongoing infusion, which belongs under A7302 rather than A7352.
• Block billed alongside surgery: A7352 is added to a surgical episode where the insurer pays the block within the anaesthetist’s fee.
• Unnamed nerve documented: the note says “peripheral nerve” or “nerve block, left leg” without naming the structure blocked.
• Wrong code for the target: a stellate ganglion or coeliac plexus block is billed as A7352 instead of its own 25000-series code.
• No pre-authorization obtained: the procedure went ahead without the approval the insurer requires.
• Clinician not recognized: the performing consultant is not recognized by the patient’s insurer for pain management or anaesthesia.

When a claim is denied, request the reason code from the insurer in writing before resubmitting. That code tells you whether to add documentation, correct the code or appeal. Claims management software that logs denial codes and tracks resubmissions stops denied claims from aging out unresolved.

A7352 vs equivalent CPT codes: A quick reference

A7352 and US CPT nerve block codes cover similar clinical territory but follow different bundling and reimbursement logic. CCSD and CPT are separate code systems, so no CCSD code is a direct billing equivalent of a CPT code. Practices with international billing may still find this crosswalk useful.

The overlap is partial. Several CPT codes include imaging guidance when performed, much as A7352 does, while CPT 64450 still allows a separate ultrasound code. Applying one system’s bundling logic to the other produces incorrect claims in both.

How practice management software simplifies A7352 billing

An A7352 claim depends on several steps staying consistent: code selection, pre-authorization, a structured note, image evidence and diagnosis pairing. Manual workflows struggle to hold all of them steady at volume.

Practice management software like Pabau supports CCSD billing for UK private practices across each of those steps. Billing staff can select A7352 from the CCSD code list without switching between payer portals.

Nerve block note templates can be built to capture the named nerve, laterality, imaging modality, agent, volume and indication. The pre-authorization reference sits on the same record as the booked procedure.

Claims are raised and tracked from that record too. A denied A7352 claim stays next to its note and pre-authorization reference, so the fix starts with the evidence already in hand.

Manage A7352 claims and pre-authorization in one place

Pabau connects nerve block documentation, CCSD code selection and insurer submission for UK private practices, so fewer A7352 claims come back queried.

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Conclusion

A7352 claims stand or fall on one fact the descriptor makes central: the block was image-guided, and the note proves it.

Build the imaging modality and saved-image confirmation into your nerve block template, next to the named nerve and laterality. The trade-off is a minute more per note against a queried claim that has to be recoded and resubmitted.

Book a demo to see how Pabau keeps nerve block notes, pre-authorization references and CCSD claims together for pain management practices.

Continue your research

Need a reference for Bupa CCSD procedure codes? Pabau’s Bupa CCSD codes guide covers the procedure code structure Bupa uses for UK private healthcare billing.

Coding a paravertebral block? CCSD code 25010 covers paravertebral block billing, another Chapter 3 procedure that sits outside A7352.

Billing a brachial plexus block in the US? CPT code 64415 explains the single-injection brachial plexus code that the A7352 crosswalk above points to.

Coding a femoral nerve block for a US payer? CPT code 64447 covers the femoral nerve block code and the documentation US payers expect with it.

Blocking a smaller peripheral nerve branch? CPT code 64450 explains the catch-all peripheral nerve code, which allows separate ultrasound billing.

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