Does 64632 require prior authorization?

No, 64632 does not require prior authorization (low confidence). No active coverage policies found for this code.

What is the Medicare reimbursement rate for 64632?

Medicare facility rate: $61.79. Non-facility rate: $90.18. Work RVU: 1.20.

HCPCS/CPT

No Prior Auth Required

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

Work RVU

1.20

Facility

$61.79

Non-Facility

$90.18

The clinical record must document the elements leading to the diagnosis and the treatment decision to use injection (history, exam findings, diagnostic rationale).
Records must be made available upon request to support coding and medical necessity determinations.
All documentation must be maintained in the patient's medical record, be legible, include full patient identification, dates of service, and the legible signature of the responsible physician or non-physician practitioner.
The submitted medical record must support the selected ICD-10-CM code(s) and the CPT/HCPCS code must accurately describe the service performed.

Injection therapy for Morton's neuroma (focal injection of tissue surrounding a localized plantar digital inflammatory focus) should be billed using CPT 64455 or 64632.
Injection therapy for plantar fasciitis is addressed and billed with CPT 20550 and corresponds to ICD-10-CM M72.2.
Injection to tendons at their origin or insertion sites should be reported using CPT 20551.
A single CPT 20551 should be reported when injections include both the plantar fascia and the area around a calcaneal spur.
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.

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.