2025 CPT code 64450
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Injection(s) of anesthetic agent(s) and/or steroid into other peripheral nerve or branch.
Modifier 50 (Bilateral Procedure) is used if the injection is performed on both sides of the body.Other modifiers may be appropriate depending on the circumstances (e.g., -25 (Significant, separately identifiable E/M service by the same physician on the same day), -59 (Distinct procedural service)).
Medical necessity for 64450 is established by the presence of a clinically diagnosed condition causing significant pain in the area innervated by the targeted peripheral nerve or branch, and the expectation that the nerve block will provide significant pain relief.The procedure should be considered medically reasonable and necessary and not for routine or prophylactic purposes.
The physician or qualified healthcare professional is responsible for preparing the patient, administering the injection(s) accurately, and monitoring the patient post-procedure.This includes selecting the appropriate anesthetic agent and steroid, determining the injection site, and ensuring appropriate documentation is completed.
In simple words: The doctor injects medicine near a nerve to numb it or reduce pain. This might help with pain relief or before another medical procedure. The injection is done once per nerve, even if multiple injections are given along that nerve.
This CPT code encompasses the injection of one or more anesthetic agents and/or steroids into a peripheral nerve or branch not specified by other codes.The procedure involves the precise administration of these substances to achieve either diagnostic or therapeutic effects, such as pain relief or desensitization of a targeted area. Imaging guidance (ultrasound, fluoroscopy, CT) and localization may be reported separately.The code is reported once per nerve, regardless of the number of injections along that nerve.
Example 1: A patient presents with chronic lateral femoral cutaneous nerve neuropathy. The physician performs a nerve block using 64450, injecting anesthetic and steroid to alleviate pain., A patient is scheduled for a surgical procedure on their hand. To ensure adequate anesthesia during the procedure, the physician administers an injection of anesthetic to a peripheral nerve branch in the wrist (64450)., A patient suffers from chronic pain in their forearm following a previous injury.The physician uses image guidance (ultrasound) to perform multiple injections of anesthetic and steroid into the affected nerves (64450, with separate imaging codes as appropriate).
* Complete patient demographics.* Diagnosis codes supporting medical necessity.* Detailed description of the procedure, including nerve targeted, type and amount of anesthetic and steroid used.* Location and number of injections.* Use of imaging guidance (if any), with specific code(s).* Physician signature and credentials.* Post-procedure notes, including patient tolerance and response.
** * 64450 should not be used for injections into plantar fasciitis. Consider CPT codes 20550 or 20551 for plantar fascia injections.*Always refer to the most current CPT codebook and payer guidelines for accurate coding and billing practices.*Documentation must clearly justify medical necessity.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- Payment Status: Active
- Specialties:* Anesthesiology* Pain Management* Orthopedics* Neurology* Neurosurgery
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center, other appropriate settings