# Adductor Canal block/Saphenous Nerve Block



## TAMMY12 (May 20, 2016)

Anesthesiologist does Adductor Canal block for lower leg pain. Following day he does a saphenous block.  Would you code 64450 for Adductor and 64447 for Saphenous?


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## dwaldman (May 22, 2016)

Per AMA CPT Assistant, they indicating to use 64447 for the adductor canal.
AMA CPT Assistant came out with the below in 2014.
 November 2014 page 14

 Frequently Asked Questions:Surgery: Nervous System

 Question: What is the correct CPT code to report for adductor canal single shot injection for a pain block? 

 Answer:The adductor canal pain block for a single shot would be reported with code 64447, Injection, anesthetic agent; femoral nerve, single. 

 Question: What is the correct CPT code for adductor canal continuous catheter pain block? 

 Answer:Code 64448, Injection, anesthetic agent; femoral nerve, continuous infusion by catheter (including catheter placement), would be reported when a continuous infusion is performed and a catheter is used.


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## sbslufkin (Aug 17, 2018)

*76942 (x2) with 64447 & 64448*

I have billed Medicare (Novitas) for CPT 64447 WITH 76942 (Ultra Sound Guidance) and CPT 64448 WITH 76942 for POST OP pain after a Total Knee Replacement.
Modifier 26 is added to CPT 76942 for both line items. Each procedure is reported as a separate line item.

98% of the time, both 76942 codes are denied and then submitted for reconsideration with the result being that only 1 pays and the other denies as a duplicate.
I have 2 images for the 2 sites, however, the provider does his dictation for both procedures on the same procedure note.

I am looking for advice on how to get the 76942 codes to pay for both without having to appeal.

Question: What is the correct way to bill TWO CPT codes 76942 (Ultra Sound Guidance) with 64447 (Adductor canal single shot injection for a pain block) and
64448 (Adductor canal continuous catheter pain block) when performed on a single patient?

Question: Do additional modifiers need to be submitted along with the modifier 26?


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## LisaAlonso23 (Aug 24, 2018)

sbslufkin said:


> I have billed Medicare (Novitas) for CPT 64447 WITH 76942 (Ultra Sound Guidance) and CPT 64448 WITH 76942 for POST OP pain after a Total Knee Replacement.
> Modifier 26 is added to CPT 76942 for both line items. Each procedure is reported as a separate line item.
> 
> 98% of the time, both 76942 codes are denied and then submitted for reconsideration with the result being that only 1 pays and the other denies as a duplicate.
> ...



If your provider performs two nerve blocks using ultrasound (76942) for both, you would only bill 76942 once with a -26.


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