2025 CPT code 64455

Injection(s) of anesthetic agent(s) and/or steroid into the plantar common digital nerve(s).

The code should be reported only once per foot, regardless of the number of injections performed in that foot. Modifier 50 is used for bilateral procedures. Imaging guidance may be separately reported in certain cases, as per the CPT guidelines.

Modifier 50 (bilateral procedure) is applicable when injections are performed on both feet.

Medical necessity is established by documentation of a clinical diagnosis consistent with the code's indication (e.g., Morton's neuroma or other plantar nerve pain), and failure of conservative management, as outlined in the documentation requirements above.Payer policies and local coverage determinations should also be considered.

The physician injects a corticosteroid (e.g., triamcinolone, methylprednisolone acetate, or prednisone) or an anesthetic substance, or both, into the plantar common digital nerve to treat Morton's neuroma or other inflammatory nerve conditions.Pre-injection assessment and post-injection monitoring are also part of the clinical responsibility.

IMPORTANT Do not report 64455 with 64632 (destruction by neurolytic agent; plantar common digital nerve).CPT 64632 is used when a neurolytic agent (higher concentration of alcohol) is used for nerve destruction, whereas 64455 is for injection of anesthetic and/or steroid.

In simple words: The doctor injects medicine (numbing medicine and/or steroid) into a nerve in the sole of the foot to help with pain or inflammation.This is often done for a condition called Morton's neuroma.

This CPT code reports the injection of one or more anesthetic agents and/or steroid(s) into the plantar common digital nerve(s), often for the treatment of conditions like Morton's neuroma.The code is reported once per foot, irrespective of the number of injections administered within that foot. Imaging guidance (ultrasound, fluoroscopy, CT) and localization may be reported separately.

Example 1: A patient presents with classic symptoms of Morton's neuroma in the third interspace of the right foot.The physician performs an injection of a local anesthetic and corticosteroid into the affected nerve using ultrasound guidance., A patient experiences persistent plantar nerve pain despite conservative management. The physician performs bilateral injections (left and right feet), each coded with 64455 and modifier 50., A patient with diabetes and peripheral neuropathy presents with pain in multiple interspaces.The physician performs injections in the second and third interspaces of the right foot, coding 64455 once, as the injections are in the same foot.

* Thorough history and physical exam documenting the diagnosis of Morton's neuroma or other relevant condition.* Documentation of conservative treatment attempts and their failure.* Detailed description of the injection procedure, including the nerve(s) targeted, type and amount of medication administered, and any imaging guidance used.* Post-procedure assessment of the patient's condition.

** The use of sclerosing agents in higher concentrations (over 30%) for neurolysis or nerve destruction necessitates the use of CPT code 64632, not 64455.Always refer to the most current CPT codebook and payer guidelines for the most accurate and up-to-date information.

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