Does 64505 require prior authorization?

No, 64505 does not require prior authorization (low confidence). No active coverage policies found for this code.

What is the Medicare reimbursement rate for 64505?

Medicare facility rate: $97.53. Non-facility rate: $150.30. Work RVU: 1.33.

HCPCS/CPT

No Prior Auth Required

No active coverage policies found for this code (low confidence)

Work RVU

1.33

Facility

$97.53

Non-Facility

$150.30

All documentation must be maintained in the patient's medical record, be legible, include patient identification on every page, and include the legible signature of the responsible physician or non-physician practitioner.
Submitted medical records must support the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
The procedural report must clearly document indications and medical necessity; for diagnostic blocks record pre- and post-procedure pain intensity using a standardized scale for the duration expected with the anesthetic used.
The patient's medical record should include the provider's assessment relating to the complaint, relevant medical history, results of pertinent tests/procedures, and a signed and dated office visit or operative report to support medical necessity.

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.
One diagnostic peripheral nerve block session per peripheral nerve (unilateral or bilateral) is considered reasonable and necessary when used for diagnostic purposes.
Steroid injections (with or without local anesthetic) are allowable treatments for Morton's neuroma and carpal tunnel syndrome.
Peripheral nerve blocks consisting of local anesthesia with or without corticosteroids and denervation procedures for chronic pain are covered when they meet the reasonable and necessary requirements in LCD DL40267.
Therapeutic radiofrequency neurolysis is covered for refractory trigeminal neuralgia only.

L40299 — Peripheral Nerve Blocks and Procedures for Chronic Pain

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A60321 — Billing and Coding: Peripheral Nerve Blocks and Procedures for Chronic Pain

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A60301 — Billing and Coding: Peripheral Nerve Blocks and Procedures for Chronic Pain

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L40266 — Peripheral Nerve Blocks and Procedures for Chronic Pain

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Ask Verity about documentation requirements, denial risks, or coverage in your state.