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

Peripheral nerve blocks (local anesthetic with or without corticosteroid) and denervation procedures for chronic pain are covered when reasonable and necessary per LCD DL40267, with diagnostic blocks allowed but limited to one session per peripheral nerve. Therapeutic radiofrequency neurolysis is covered only for refractory trigeminal neuralgia and is limited to two procedures per rolling 12 months; steroid injections for Morton's neuroma and carpal tunnel syndrome are limited to 2 and 3 lifetime injections per side respectively. Several exclusions and billing restrictions apply (e.g., systemic peripheral neuropathy, dry needling, non-FDA biological injectants), and detailed documentation and ABN/modifier requirements must accompany claims.

"Peripheral nerve blocks consisting of local anesthesia with or without corticosteroids and denervation procedures for chronic pain are covered when they meet the reasonable and necessary requiremen..."