2025 CPT code 64400

Injection(s) of anesthetic agent(s) and/or steroid into a branch of the trigeminal nerve; reported per branch injected.

Refer to the most current CPT manual for detailed guidelines on coding nerve blocks.Specific instructions may vary by the anatomical location of the nerve and the use of imaging guidance.Note the rules for reporting bilateral procedures (modifier 50). Multiple injections on the same branch are reported once; the code is reported based on the number of branches injected, not the number of injections.

Modifiers may apply depending on the circumstances of the procedure (e.g., modifier 50 for bilateral procedures, -25 if performed with an E/M service). Refer to the CPT manual for details and payer guidelines.

Medical necessity for this procedure is established by documentation of a specific diagnosis such as trigeminal neuralgia or postherpetic neuralgia, with clear evidence of pain in the trigeminal nerve distribution.The benefits of the nerve block to alleviate pain should outweigh the risks of the procedure.Payers may have additional criteria for medical necessity that should be checked before submitting a claim.

The physician performs the injection procedure after appropriate patient preparation.This may be for diagnostic or therapeutic purposes to treat conditions such as trigeminal neuralgia or postherpetic neuralgia. The physician must accurately identify the specific trigeminal nerve branch to ensure proper coding.

IMPORTANT For injection or destruction of genicular nerve branches, use codes 64454 and 64624 respectively.For intracranial surgery on cranial nerves, see 61450, 61460, 61790. For destruction by neurolytic agent or chemodenervation, see 62280-62282, 64600-64681. For epidural or subarachnoid injection, see 62320-62327. Codes 64400-64455, 64461, 64462, 64463, 64479, 64480, 64483, 64484, 64490-64495 are unilateral procedures.Modifier 50 should be used for bilateral procedures for most codes in this range. Add-on codes64421, 64462, 64480, 64484, 64491, 64492, 64494, 64495 are reported twice when performed bilaterally without modifier 50.

In simple words: The doctor injects medicine near a branch of the trigeminal nerve in your face to numb the area or treat pain.The code is used for each separate branch of the nerve treated.

This CPT code reports the injection of anesthetic agent(s) and/or steroid into each branch of the trigeminal nerve (ophthalmic, maxillary, and/or mandibular).The code is reported once per branch injected, regardless of the number of injections performed within that branch during a single procedure. Imaging guidance and localization may be reported separately, unless specified otherwise within the inclusive components of other related codes.

Example 1: A patient presents with trigeminal neuralgia affecting the ophthalmic branch. The physician performs a trigeminal nerve block, injecting anesthetic and steroid into the ophthalmic branch. Code 64400 is reported., A patient experiences severe pain in their maxillary region due to postherpetic neuralgia.The physician injects anesthetic and steroid into the maxillary branch of the trigeminal nerve.Code 64400 is reported., A patient has pain in both the mandibular and maxillary branches of the trigeminal nerve.The physician injects anesthetic and steroid into each branch separately. Code 64400 is reported twice.

Detailed documentation is needed, including the specific trigeminal nerve branch(es) injected (ophthalmic, maxillary, mandibular), the type and amount of anesthetic and/or steroid used, the location of the injection, and a clear clinical indication for the procedure (e.g., diagnosis of trigeminal neuralgia, postherpetic neuralgia).Pre-operative and post-operative notes, including patient response to the injection, should also be documented. Imaging reports should be included if imaging guidance was used.

** Always verify payer-specific coding guidelines and coverage policies before submitting claims.The number of injections within a single branch is not separately reported; only the number of branches injected is relevant for coding.

  • Revenue Code: P6C (MINOR PROCEDURES - OTHER)
  • RVU: This information is not available in the provided source.Relative Value Units (RVUs) vary by location, payer, and other factors. Consult a relevant fee schedule for specific RVU values.
  • Global Days : The global period for this procedure is not specified in the provided source.Consult the payer's guidelines for details on the global surgical period.
  • Payment Status: Active
  • Modifier TC rule: This information is not provided in the source.Determine based on payer guidelines and clinical context.
  • Fee Schedule : Historical fee schedule information is not available in the provided text.Consult the AMA's CPT codebook or payer-specific fee schedules for this information.
  • Specialties:Anesthesiology, Pain Management, Neurology, Neurosurgery
  • Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center, other settings as clinically appropriate.
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