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NCCI Policy Manual for Medicare Services – Effective January 1, 2017

CPT codes 64400-64530 describe injection of anesthetic agent for diagnostic or therapeutic purposes, the codes being distinguished from one another by the named nerve and whether a single or continuous infusion by catheter is utilized. All injections into the nerve including branches described (named) by the code descriptor at a single patient encounter constitute a single unit of service(UOS). For example:

(1) If a physician injects an anesthetic agent into multiple areas around the sciatic nerve at a single patient encounter, only one UOS of CPT code 64445 (injection, anesthetic agent; sciatic nerve, single) may be reported.

2) If a physician injects the superior medial and lateral branches and inferior medial branches of the left genicular nerve, only one UOS of CPT code 64450 (Injection, anesthetic agent; other peripheral nerve or branch) may be reported regardless of the number of injections needed to block this nerve and its branches.

Below are the new epidural codes proposed by Medicare that will further delineate epidural injections performed with image guidance from those preformed using a landmark loss-of resistance or hanging-drop technique. Medicare has not yet disclosed what number will ultimately be inserted to replace the X placeholder when the final rule is released. SPPM will keep you posted.

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