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

This policy covers peripheral nerve blocks (local anesthetic ± corticosteroid) and denervation procedures for chronic non-cancer pain when reasonable and necessary per LCD DL40265, with diagnostic blocks limited to one session per peripheral nerve. Therapeutic radiofrequency neurolysis is restricted to refractory trigeminal neuralgia and steroid injections for Morton's neuroma and carpal tunnel syndrome have lifetime per-side caps (2 and 3 respectively); multiple same-day procedures, use of non-FDA biologic injectants, dry needling, and certain billing/anesthesia practices are explicitly limited or non-covered and detailed documentation is required.

"Peripheral nerve blocks (local anesthesia with or without corticosteroids) and denervation procedures are covered for chronic non-cancer pain when reasonable and necessary per LCD DL40265."

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