Billing and Coding: Peripheral Nerve Blocks and Procedures for Chronic Pain

This policy specifies billing/coding and coverage constraints for peripheral nerve blocks (PNBs) and denervation procedures for chronic pain per LCD DL40263. Covered indications include PNBs/denervation for chronic pain and certain neuropathic conditions (refractory trigeminal neuralgia, carpal tunnel syndrome, Morton's neuroma), while PNBs and radiofrequency neurolysis are non-covered for systemic peripheral neuropathy, generalized chronic pain, and most neuropathic pain. The policy also defines documentation requirements, coding modifiers and facility-specific billing rules, and sets clear frequency limits (e.g., 1 diagnostic block per peripheral nerve, lifetime limits for steroid injections, and a 2-per-12-month limit for therapeutic radiofrequency neurolysis).

"Peripheral nerve blocks (PNBs) using local anesthesia with or without corticosteroids and denervation procedures for chronic pain are covered when they meet the reasonable and necessary criteria in..."