Does 76882 require prior authorization?

Yes, 76882 requires prior authorization (medium confidence). Conditional coverage; review criteria to confirm PA need.

What is the Medicare reimbursement rate for 76882?

Medicare facility rate: $3.41. Non-facility rate: $3.41. Work RVU: 0.67.

HCPCS/CPT

Prior Auth Required

Conditional coverage; review criteria to confirm PA need (medium confidence)

Work RVU

0.67

Facility

$3.41

Non-Facility

$3.41

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.
Submitted medical records must support the selected diagnosis code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
The patient's medical record must contain documentation that fully supports medical necessity, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Each claim must be submitted with ICD-10-CM codes that reflect the patient's condition and the reason for the service; claims without ICD-10-CM codes will be returned.

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).
Nonvascular extremity ultrasound is covered when medical necessity is documented in the patient's record, including relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Diagnostic nonvascular extremity ultrasound is covered when the claim includes an ICD-10-CM diagnosis code that best describes the patient's condition and the test result or the symptoms prompting the test are documented.
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 injection/nerve block for peripheral neuropathy may be covered when the medical record documents that the service is medically necessary for the patient's specific condition.

A57589 — Billing and Coding: Nerve Blocks for Peripheral Neuropathy

J05

L35222 — Nerve Blocks for Peripheral Neuropathy

J05

A56787 — Billing and Coding: Nonvascular Extremity Ultrasound

J06

L33619 — Nonvascular Extremity Ultrasound

J06

L33693

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