64450
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.73
Facility
$38.41
Non-Facility
$80.83
Documentation Required
- The performing provider must maintain medical record documentation that clearly supports the medical necessity of the billed service and include that documentation in the patient's record for review upon request.
- Documentation should state whether the block was diagnostic or therapeutic, include pre- and post-procedure evaluations, and document patient education and the assessment of procedural outcome.
- Documentation must support coverage criteria in the LCD 'Indications and Limitations of Coverage and/or Medical Necessity' section and the provider should document why services cannot be rendered by the surgeon when applicable.
- For services requiring a referring/ordering physician, the referring/ordering physician's name and NPI must be reported on the claim.
Key Coverage Criteria
- CPT codes 64400-64530 for peripheral nerve blocks may be reported on the date of surgery when performed for postoperative pain management only if the operative anesthesia is general anesthesia, subarachnoid injection, or epidural injection and the adequacy of intraoperative anesthesia is not dependent on the peripheral nerve block.
- Peripheral nerve block services that are separate, medically necessary services which cannot be rendered by the surgeon may be reported if the surgeon documents the reason for referral and the additional services are justified in the medical record.
- CPT 64450 is appropriate when a qualified health care professional performs a direct injection (nerve block) of an anesthetic agent and/or steroid into a peripheral nerve for treatment of peripheral neuropathy.
- Code 64450 addresses the additional work of performing a nerve block (direct peripheral nerve injection) rather than injections into surrounding subcutaneous tissue.
- Peripheral nerve blocks (local anesthesia with or without corticosteroids) and denervation procedures are covered for chronic non-cancer pain when reasonable and necessary per LCD DL40265.
- Therapeutic radiofrequency neurolysis is covered only for refractory trigeminal neuralgia.
20 Active Policies
L40299 — Peripheral Nerve Blocks and Procedures for Chronic Pain
J05
A60321 — Billing and Coding: Peripheral Nerve Blocks and Procedures for Chronic Pain
J05
A57589 — Billing and Coding: Nerve Blocks for Peripheral Neuropathy
J05
L35222 — Nerve Blocks for Peripheral Neuropathy
J05
Related Codes
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