# Genicular Nerve Block



## mgrimaldi (Oct 31, 2013)

If a physician is injecting multiple areas of the genicular nerve - (superior lateral, superior medial and inferior medial) would you bill 1 - 64450 or would you bill it quantity 3?


----------



## dwaldman (Oct 31, 2013)

I was looking at if it was 3 separate branches with 3 separate injections. But couldn't find a lot information on the procedure in question. Hope you get an answer.

Injection, anesthetic agent; other peripheral nerve or branch 

Branches

nerves

Common peroneal nerve

�      slopes downwards on lateral side

�      medial to biceps tendon

�      disappears into substance of peroneus longus

�      lies on neck of fibula

�      lies successively on

�      plantaris

�      lateral head of gastrocnemius

�      capsule of knee joint

�      fibular origin of soleus

�      divides into deep and superficial peroneal nerves


Peroneal communicating nerve

�      pierces roof of fossa

�      runs down to join sural nerve

Lateral cutaneous nerve of calf

�      peirces roof of fossa

�      supplies skin over upper anterolateral leg

Genicular nerves

�      superior and inferior lateral

�      travel with arteries of same name

�      supply lateral knee jt

�      recurrent genicular

�      arises in substance of peroneus longus

�      perforates tibialis anterior

�      supplies capsule of superior TF jt and knee jt

Tibial nerve

�      runs vertically down middle of fossa

�      passes deeply between heads of gastrocnemius

�      passes beneath fibrous arch of soleus

�      enters calf

Branches

Sural nerve

�      runs down superficially between heads of gastrocnemius

�      pierces fascia halfway down calf

�      replaces posterior cutaneous nerve of thigh

�      joins peroneal communicating nerve

�      close to small saphenous nerve

Genicular nerves

�      superior and inferior medial

�      accompany arteries of same name

�      supply medial knee joint

�      middle

�      accompanies artery of same name

�      pierces oblique popliteal ligament

�      supplies cruciates


----------

