64510
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
1.19
Facility
$69.81
Non-Facility
$153.98
Documentation Required
- All documentation must be maintained in the patient's medical record, be legible, include appropriate patient identification (e.g., full name, dates of service), and be available to the contractor upon request.
- The medical record must identify the physician or non-physician practitioner responsible for and providing the care.
- The submitted medical record must support the selected diagnosis code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
- Medical records must be maintained and available upon request; every page must be legible and include patient identification (e.g., full name, dates of service) and identify the physician or non-physician practitioner responsible for care.
Key Coverage Criteria
- Regional or local nerve blocks performed as part of an operative procedure (e.g., adjunct to or sole means of regional/local anesthesia for the procedure) are not affected by this non-coverage policy and may be billed as anesthesia for the operative procedure.
- Regional or local nerve blocks performed as an adjunct to, or as the sole means of, regional/local anesthesia for an operative procedure are not affected by this noncoverage policy (i.e., such intraoperative regional/local anesthesia is allowed).
- Peripheral nerve blocks (local anesthesia with or without corticosteroids) and denervation procedures are covered for chronic pain when they meet the reasonable and necessary requirements in LCD DL40261 and are not for cancer-related pain, spasticity, or perioperative/operative anesthesia.
- Therapeutic radiofrequency neurolysis is covered for refractory trigeminal neuralgia.
- Steroid injections with or without local anesthetic are allowable therapies for Morton's neuroma and carpal tunnel syndrome when medically necessary and documented.
- Peripheral nerve blocks (PNBs) using local anesthesia with or without corticosteroids and denervation procedures for chronic pain are covered when they meet the reasonable and necessary criteria in LCD DL40263.
20 Active Policies
A60321 — Billing and Coding: Peripheral Nerve Blocks and Procedures for Chronic Pain
J05
L40299 — Peripheral Nerve Blocks and Procedures for Chronic Pain
J05
L40266 — Peripheral Nerve Blocks and Procedures for Chronic Pain
J06
A60301 — Billing and Coding: Peripheral Nerve Blocks and Procedures for Chronic Pain
J06
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.