76999
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
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).
- 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.
- Nerve block evaluation and treatment is indicated for chronic pain defined as pain present continuously or intermittently for >= 3 months despite prior therapy.
14 Active Policies
L35222 — Nerve Blocks for Peripheral Neuropathy
J05
A57589 — Billing and Coding: Nerve Blocks for Peripheral Neuropathy
J05
A57663 — Billing and Coding: Nerve Blocks for Peripheral Neuropathy
L35249 — Nerve Blocks for Peripheral Neuropathy
L35456 — Nerve Blockade for Treatment of Chronic Pain and Neuropathy
Related Codes
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