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We have some providers who want to start performing the PENG Nerve Block and the 4 in 1 Block for postop pain management. I have been looking around and haven’t had any luck finding a source for a CPT code for these procedures. Should the unlisted 64999 be used?
Thanks
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.
could some one help with coding below, should I code Biopsy with Peripheral nerve block ? do I need any modifier?
PREOPERATIVE DIAGNOSES:
1. Right middle finger necrosis.
2. Right middle finger infection.
POSTOPERATIVE DIAGNOSES:
1. Right middle finger necrosis.
2. Right middle finger infection.
PROCEDURES:
1. Right middle finger irrigation and debridement of open wound.
2. Right middle finger neurectomy of radial and ulnar digital nerve.
3. Right middle finger amputation at proximal interphalangeal joint.
Code 26952
4. Peripheral nerve block radial nerve and the proper median
nerves
Code 64450
5. Biopsy: Profundus and superficialis tendons
were retracted and cut. The extensor tendon was then cut as well. The PIP
joint was disarticulated
bipsy code 26110
6. Fluoroscopic exam
Thank you
Should modifier 59 be added to 93005-EKG for RT bundle branch block (distinct procedural service)
If a facet nerve block (64490-64495) or ablation spans two spinal regions, since the description in the additional level CPT codes indicate the regions (ie 64491-64492 indicate cervical or thoracic and 64494-64495 indicate lumbar or sacral), does that mean, you would jump to the primary code of the next spinal region for the additional levels?
For example, T11-L2 facet nerve block. Would it be 64490 for T11-12, 64491 for T12-L1, & 64493 for L1-2 or should the L1-2 be coded as 64492?
The only guideline I can find is in the NCCI where it talks about procedures done at contiguous spine levels but it mentions if the additional level code doesnt indicate the spine region that you would use the add on code rather than another primary code.
Thanks!
Thank you!
I work for a neurology office – having some difficulty with a bundling issue.
On an extreme case I could bill for one patient:
64450
64405
20553
64615
96372
How i was trained – typically I would use:
64450 – 50, 59
64405 – 59
20553
64615
96372 – 59
BCBS – pays for all minus 20553 – UHC pays for 64615/96372 and 64405 – but not 20553/64450
We have a lot of UHC patients so i’m wondering if anyone has any advice
I’ve tried leaving 64450/64405/20553 blank as i’ve seen suggested for someone else – they bundled – i’ve tried using 51 modifier, which then 20553/64450 was paid but not 64405
Appreciate any advice – thanks so much!