I have an MD who performs nerve blocks as part of his pain management. Frequently he states he’s doing a "saphenous nerve block". This procedure takes several injections from about mid thigh to the calcaneous. In the past he used CPT code 64450 however since Medicare has stopped paying this code without treatment notes (5/1/17) we’ve had mixed results with submitting the notes with the claims. Oddly, this happens with the same DX codes and very similar treatment notes and the same patients only weeks if not months apart..
At times he appears as if he should be using 64447 femeral nerve block but I’m not finding anything that really describes this procedure. He’ll mention that he’s performing a series of injections along the femeral nerve.
Part of me wonders if the problem isn’t the varied manner in which he describes the procedures.
Has anyone had success billing the 64450 to Medicare with reliable results? As to date I’ve appealed this code 20 times in the past few months and only 10 of those claims have been paid. He’s frustrated as am I but I need some guidance.
Thank you