Hi All, I have very little information for this procedure. It hasn’t been performed as of yet, but I want to be sure my research feet are guiding me in the right direction and I haven’t overlooked something.

The inferior rectal nerves are also known as the inferior anal nerves or the inferior hemorrhoidal nerves.

This nerve(s) usually branches from the pudendal nerve (First Branch), but could occasionally branch from the sacral plexus.

Does anyone agree that if for this patient, anatomically speaking, that if the inferior rectal nerve does branch from the pudendal nerve, we could code the pudendal nerve block (64430), but if the inferior rectal nerve branches from the sacral plexus, we would bill the other peripheral nerve block code (64450)?

Thanking you in advance for additional thoughts.