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2025 CPT code 64446

Continuous infusion of anesthetic and/or steroid into the sciatic nerve, including catheter placement and imaging guidance.

Imaging guidance is included in 64446 and should not be reported separately. For bilateral procedures, use modifier 50. Modifier 59 may be necessary in specific postoperative pain management scenarios.

Modifiers such as 50 (bilateral), 59 (distinct procedural service), and others may be applicable depending on the circumstances. Refer to current CPT guidelines.

Medical necessity must be established by documenting the diagnosis and rationale for the continuous sciatic nerve block. The documentation should support the expected improvement in pain and function.

The physician locates the sciatic nerve, often using an insulated needle and observing motor response. Imaging guidance helps visualize the nerve. A catheter is then inserted, the needle removed, and the catheter secured. A continuous infusion of medication is then started.

In simple words: A catheter is placed near the sciatic nerve in your leg, and pain medication and/or anti-inflammatory medicine is continuously delivered through it. Imaging is used to guide the procedure.

Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed. Do not report 64446 in conjunction with 01996, 76942, 77002, 77003.

Example 1: A patient with chronic sciatica requires continuous infusion of anesthetic and steroid medication for pain relief. Code 64446 is used to report the catheter placement and infusion., A patient experiences severe leg pain after surgery. A continuous sciatic nerve block is administered via catheter, reported with 64446, to manage post-operative pain., A patient with complex regional pain syndrome affecting the leg undergoes a continuous sciatic nerve block using a catheter and infusion, reported with 64446, as part of their pain management plan.

Documentation should include details of the procedure, including imaging guidance confirmation, medication used, catheter placement specifics, and the patient's response.

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