2025 CPT code 64445

Injection(s) of anesthetic agent(s) and/or steroid into the sciatic nerve, including imaging guidance.

Codes 64400-64489 describe injections into the somatic nervous system.64445 is reported once per sciatic nerve regardless of the number of injections along the nerve. Modifier 50 is used for bilateral procedures. Imaging guidance is included in 64445 and is not reported separately.

Modifiers may be applicable to this code. Modifier 50 is used to indicate a bilateral procedure. Other modifiers, such as those indicating reduced services (52) or discontinued procedures (53), may also be appropriate in certain circumstances.

Medical necessity for this procedure must be clearly documented. This may include failed conservative treatments, imaging studies confirming nerve impingement or inflammation, and functional limitations due to sciatic nerve pain. The documentation should link the injection to the patient's diagnosis and demonstrate how it will improve their condition.

The physician prepares the patient and administers the injection(s) into the sciatic nerve using a needle and syringe. They select the appropriate anesthetic agent(s) and/or steroid based on the patient's condition and needs. Imaging guidance may be used to visualize the procedure.

IMPORTANT For continuous infusion of anesthetic and/or steroid via catheter for the sciatic nerve, see 64446.

In simple words: The doctor injects medicine into the area around your sciatic nerve in your leg to help relieve pain.They may use imaging, like an ultrasound, to help guide the needle.

This code describes the injection of one or more anesthetic agents and/or steroids into the sciatic nerve.It includes imaging guidance, such as ultrasound, fluoroscopy, or CT, when performed. The code is reported for one or more injections during a single procedure.Imaging guidance is an inclusive component of this code and should not be reported separately.

Example 1: A patient with chronic sciatica receives a steroid injection into the sciatic nerve under ultrasound guidance to reduce inflammation and pain., A patient experiences post-operative pain following hip surgery. An anesthetic injection is administered into the sciatic nerve to provide pain relief during physical therapy., A patient with a herniated disc causing sciatic nerve impingement receives an injection of anesthetic and steroid into the sciatic nerve to reduce pain and improve mobility.

Documentation should include the diagnosis supporting the medical necessity of the injection, the specific anesthetic agent(s) and/or steroid used, the location of the injection (sciatic nerve), and any imaging guidance used.If imaging guidance is used, a separate report interpreting the images should be included.

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