# Injections 64455, 64640



## maina03 (Sep 24, 2013)

I work for a podiatry practice... the doctors are giving injections with alcohol for neuroma treatment...and sending 64640 in the superbill...medicare doesn't pay for that combination as the correct treatment should be 64455 but they don't give steroid injections....
is there a better code for the alcohol injections for neuroma treatment?


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## maina03 (Sep 24, 2013)

*never mind fount it 64632*

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According to Medicare guidelines CPT 64632 for destruction by neurolytic agent of the is the corrected CPT to bill for a Morton's neuroma and CPT 64455 is for anesthetic agent and/or steroid for a Morton's neuroma. In guide line for Medicare it specifically states not to use 64640 for a Morton's neuroma.

From WPS Final Comments for Injections-Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma: Morton's neuromas injections do not involve the structures described by CPT codes 20550 and 20551 or direct injection into other peripheral nerves but rather the injection of tissue surrounding a specific focus of inflammation on the foot. These therapies are not to be coded using CPT codes 20550, 20551, 64450, or 64640. Most specifically, the provider must not bill CPT codes 64450 or 64640 for these injections, since those codes respectively address the additional work of an injection of an anesthetic agent (nerve block), eurolytic or sclerosing agent into relatively more difficult peripheral nerves, rather than that involved in an injection of relatively easily localized areas. Morton's neuroma is included in the description of CPT code 64455 in the CPT manual.
__________________
Tammy Hulsey-Ferguson, CPC
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Wichita, KS Local Chapter


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