2025 CPT code 64418

Injection(s) of anesthetic agent(s) and/or steroid into the suprascapular nerve.

Refer to the official CPT coding guidelines for detailed instructions on coding nerve blocks.

Modifier 50 (bilateral procedure) may be used if injections are performed on both sides.Modifiers may be used for other scenarios as per the official CPT guidelines.

Medical necessity for a suprascapular nerve block is typically established when conservative treatments (e.g., physical therapy, medication) have failed to provide adequate pain relief for conditions such as rotator cuff tendinopathy, bursitis, or adhesive capsulitis.The procedure is also medically necessary for postoperative analgesia and in cases of diagnostic uncertainty.

The physician or qualified healthcare professional is responsible for selecting the appropriate anesthetic and steroid, preparing the injection site, performing the injection using appropriate technique, and monitoring the patient for any adverse reactions.

IMPORTANT Related codes include other nerve blocks (e.g., 64400-64450, 64454) depending on the specific nerve targeted.Refer to CPT guidelines for appropriate code selection.

In simple words: The doctor injects medicine near a nerve in your shoulder (suprascapular nerve) to relieve pain or to help diagnose a problem.They may use imaging to guide the injection.

This CPT code describes the injection of one or more anesthetic agents and/or steroids into the suprascapular nerve.The procedure involves the percutaneous injection of the anesthetic and/or steroid near the suprascapular nerve to provide analgesia or for diagnostic purposes.Imaging guidance may be used but is not included in the code and should be billed separately.

Example 1: A patient presents with chronic shoulder pain secondary to rotator cuff tendinopathy.The physician performs a suprascapular nerve block to provide pain relief., A patient is undergoing shoulder surgery. The physician performs a suprascapular nerve block for postoperative analgesia. , A patient presents with unexplained shoulder pain. The physician performs a diagnostic suprascapular nerve block to determine if the suprascapular nerve is the source of pain.

** More than three injections per anatomic site (suprascapular nerve) in a six-month period may be denied by some payers.Proper documentation is crucial for appropriate reimbursement.

  • Revenue Code: P6C (Minor Procedures - Other)
  • RVU: Refer to CMS fee schedule for current RVU values.Values will vary by geographic location and facility type.
  • Global Days : Not applicable for this procedure.
  • Payment Status: Active
  • Modifier TC rule: Not applicable.
  • Fee Schedule : The historical fee schedule for this code can vary greatly depending on the payer, location, and time period. Consult fee schedules specific to the relevant payer and location.
  • Specialties:Anesthesiology, Pain Management, Orthopedic Surgery
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgery Center
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