M79.669 — Pain in unspecified lower leg
ICD-10-CM
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- Claims and coding must follow the Local Coverage Determination L37642 that this article complements; medical record documentation should support the billed service in accordance with LCD L37642.
- All documentation must be maintained in the patient’s medical record and be legible with appropriate patient identification (e.g., complete name, dates of service) on every page.
- The record must identify the physician or non-physician practitioner responsible for and providing the care to the patient.
- The submitted medical record must support the selected diagnosis code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.
Key Coverage Criteria
- 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.
- Duplex scanning is covered only when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33674.
- Coverage for amniotic and placental-derived product injections/applications for musculoskeletal, non-wound indications is determined by Local Coverage Determination L39139; consult LCD L39139 for specific clinical indications and thresholds.
- Coverage applies when the amniotic or placental-derived product injection/application meets the reasonable and necessary requirements of Local Coverage Determination L39877.
- Amniotic and placental-derived product injections/applications are covered only when they meet the reasonable and necessary clinical requirements specified in LCD L39879 (Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound).
20 Active Policies
L39624 — Amniotic and Placental Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound
J05
A59434 — Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound
J05
L35222 — Nerve Blocks for Peripheral Neuropathy
J05
A57589 — Billing and Coding: Nerve Blocks for Peripheral Neuropathy
J05
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.