# Please Help!!!



## pajohnson (Jan 13, 2014)

Hello fellow coders,
I am in need of some clarification on the nerve block codes.  Can anyone confirm that the CPT code that I have next to it is correct?  This is to help resolve an office dispute!!Thanks in advance for any responses.  If it is not correct, please put the correct code.

Interscalene-64415
Supraclavicular-64415
Infraclavicular -64415
Axillary-64415 
Suprascapular-64415  
Femoral-64447  
Obturator-??  
Saphenous-64417  
Fascia Iliaca-64445 
Sciatic-64445
Popliteal-64450   
Ankle-64450  
Lumbar Plexus-64450  
Saphenous-64447


----------



## dwaldman (Jan 13, 2014)

Here are the corrections I placed below. Remember a branch of the femoral or sciatic is not coded as the primary nerve code 64447 or 64445. It is coded as other peripheral branch. 



Obturator--64450
Saphenous---66450
Lumbar plexus----64999
fascia iliac----64450

http://www.nysora.com/techniques/ne.../landmark-based/3282-lumbar-plexus-block.html


Anatomy and Sonoanatomy

Lumbar plexus block, also known as psoas compartment block, comprises an injection of local anesthetic in the fascial plane within the posterior aspect of the psoas major muscle. Because the roots of the lumbar plexus are located in this plane, an injection of a sufficient volume of local anesthetic in the postero-medial compartment of the psoas muscle results in block of the majority of the plexus (femoral nerve, lateral femoral cutaneous nerve, and the obturator nerve).



http://www.nysora.com/techniques/ul...-ultrasound-guided-saphenous-nerve-block.html


General Considerations


The saphenous nerve is the terminal sensory branch of the femoral nerve. It supplies innervation to the medial aspect of the leg down to the ankle and foot. Blockade of the nerve can be sufficient for superficial procedures in this area; however, it is most useful as a


http://www.nysora.com/techniques/ne...er-extremitya/3028-obturator-nerve-block.html


Anatomy


The obturator nerve is a mixed nerve which in most cases, provides motor function to the adductor muscles and cutaneous sensation to a small area behind the knee. It is derived from the anterior primary rami of L2, L3 and L4, 




http://www.nysora.com/updates/3107-ultrasound-guided-fascia-iliaca-block.html


General Considerations


Fascia iliaca block is a low-tech alternative to a femoral nerve or a lumbar plexus block. The mechanism behind this block is that the femoral and lateral femoral cutaneous nerves lie under the iliacus fascia. Therefore, a sufficient volume of local anesthetic deposited beneath the fascia iliaca, even if placed some distance from the nerves, has the potential to spread underneath the fascia and reach these nerves. Traditionally, it was believed that the local anesthetic could also spread underneath fascia iliaca proximally toward the lumbosacral plexus; however, this has not been demonstrated consistently.


----------



## dwaldman (Jan 13, 2014)

Suprascapular has it's own code 64418


----------



## marvelh (Jan 13, 2014)

Axillary nerve block has its own code also 64417, not 64415


----------

