Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy

Medicare does not cover nerve blockade or electrical stimulation for metabolic peripheral neuropathy, including diabetic peripheral neuropathy, as these treatments are not supported as reasonable and necessary; such claims are subject to review and recoupment. The policy does not apply to regional/local nerve blocks performed as anesthesia during operative procedures. Documentation must be legible, identify the patient and responsible clinician, and support the diagnosis and CPT/HCPCS codes billed; billing fluoroscopy (77002/77003) with modifier 59 is inappropriate when the imaging is included in the billed procedure description for the same provider on the same date.

"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."

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