2025 CPT code 64454
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Nervous System Procedures Surgery Feed
Injection(s) of anesthetic and/or steroid into genicular nerve branches; includes imaging guidance if performed.
Modifier 52 (reduced services) is applicable if not all three genicular nerve branches are injected. Modifier 50 (bilateral procedure) is not applicable to 64454 because the code inherently is for unilateral procedures.Consult the current modifier guidelines for other potential modifiers.
Medical necessity for genicular nerve injections is typically established when conservative treatments (e.g., physical therapy, medication) have failed to provide adequate pain relief. The injection aims to alleviate pain associated with osteoarthritis, post-surgical knee pain, or other conditions affecting the knee joint innervation. Documentation should clearly support the need for the procedure based on the patient's clinical presentation and response to prior interventions.
The physician performs the injection procedure, including selecting the injection site(s), inserting the needle, administering the anesthetic and/or steroid, and withdrawing the needle.Pre-procedural preparation (e.g., local anesthetic injection) and imaging guidance (if used) are typically included. Post-procedure monitoring is also the physician's responsibility.
In simple words: The doctor injects medicine to numb and/or reduce swelling around the nerves in the knee.This helps relieve knee pain.Special imaging may be used, but it's included in the cost. If not all nerves are treated, the doctor will use a modifier to reflect the reduced service.
This CPT code encompasses the injection of anesthetic agent(s) and/or steroid(s) into the genicular nerve branches (superolateral, superomedial, and inferomedial) that supply the knee joint.Imaging guidance (fluoroscopy or CT) is included in the code and should not be reported separately.The procedure is performed to diagnose or treat knee pain resulting from chronic osteoarthritis, degenerative joint disease, post-surgical knee pain (following partial or total knee replacement), or in patients unsuitable for or declining knee replacement.Modifier 52 (reduced services) is required if all three genicular nerve branches are not injected. This code should not be reported together with 64624 (destruction of genicular nerve branches).
Example 1: A 68-year-old female presents with chronic knee pain due to osteoarthritis.The physician performs a genicular nerve branch injection using fluoroscopic guidance, injecting all three branches.All three branches are injected. No modifier is needed., A 72-year-old male with post-knee replacement pain undergoes a genicular nerve injection.Due to anatomical variations, only the superolateral and superomedial branches are injected. Modifier 52 is appended to 64454., A 55-year-old patient experiences persistent knee pain after a fall.The physician performs a genicular nerve injection with ultrasound guidance.All three branches are successfully injected. No modifier is appended, as ultrasound guidance is an inclusive component of this code.
* Detailed history and physical examination documenting the nature and location of knee pain.* Imaging studies (if used), including pre-injection and post-injection images (if applicable).* Documentation of which genicular nerve branches were injected and the volume of each injected substance.* Procedure note indicating technique used, any complications encountered, and patient response to the injection.* Assessment of pain relief and functional improvement following the injection.
** Accurate documentation is paramount for appropriate coding and reimbursement of 64454.Payer policies may vary, so refer to the specific payer guidelines for any additional requirements or limitations.Always use the most current CPT codebook for accurate coding.
- Revenue Code: P6C (Minor Procedures - Other)
- RVU: Data unavailable. Refer to CMS fee schedules for current RVU values.
- Global Days: Data unavailable.Global surgical period may vary based on payer and local practice guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable.This procedure does not involve separate professional and technical components.
- Fee Schedule: Data unavailable. Consult historical CPT fee schedules for relevant information.
- Specialties:Anesthesiology, Pain Management, Orthopedics
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center