This injection is a little confusing for me, I know it’s per nerve or branch. But I keep getting a little stuck on this one. My doctors note reads: I identified the right lateral superior genicular nerve branch at the junction of the lateral femoral shaft and lateral condyle; the right medial superior genicular nerve branch, at the junction of the medial femoral shaft and medial condyle; and the right medial inferior genicular branch, at the junction of the medial tibial shaft and condyle. Local anesthetic administration was performed using 2mL of lidocaine 1% at each location. Then using a 22-gauge spinal needle was directed to each end point identified above, confirming proper positioning under fluoroscopy in AP view. After negative aspiration, we injected consisting of 1.5mL of 0.25% bupivicaine and 10mg of Depo-Medrol and each branch of the genicular nerve.

I know 64450 is usually 1 UOS since it’s per nerve or branch My doctor wants to bill 3 UOS.

Any input would be helpful.

I need clarification from someone in the pain management world. My provider is performing a genicular nerve blocks where he indicates he injected the superior medial and lateral epicondyles of the femur as well as the distal aspects of the medial tibial epicondyle. I have read that CPT 64450 is per nerve or branch not per injection. Per my physician he gave the injections into different branches of the femoral nerve. How would I code this? 64450 only once? 64450 with 3 units? 64450 on multiple lines with -51 modifier? Any help is appreciated.

I need clarification from someone in the pain management world. My provider is performing a genicular nerve blocks where he indicates he injected the superior medial and lateral epicondyles of the femur as well as the distal aspects of the medial tibial epicondyle. I have read that CPT 64450 is per nerve or branch not per injection. Per my physician he gave the injections into different branches of the femoral nerve. How would I code this? 64450 only once? 64450 with 3 units? 64450 on multiple lines with -51 modifier? Any help is appreciated.

I am looking for clarification and coding help for CPT code 64450. Our pain management provider performed a genicular nerve block on a patient. He indicated in his note that he injected the superior medial and laeral epicondyles of the femur as well as the distal aspect of the medial tibial epicondyle. I am reading that CPR code 64450 is billed only once per nerve or branch, not per injection. I spoke with the provider and he stated that the 3 injections were into 3 separate branches of the femoral nerve, which is of course 3 branches but 1 nerve, so I am confused. I have also found articles that indicate to bill with 3 units with a 51 modifier. If someone in the pain management world can help shed some light on this subject I would appreciate it. Thank you in advance.