# Frequency of 64450 nerve block?



## tienacious (Aug 30, 2013)

I got this from a 2010 posted Q&A in this forum:

http://emcrit.org/ultrasound/ankleblocks.htm


"Terminal branches of the sciatic nerve in the ankle region are: 

tibial nerve 
superficial peroneal nerve 
deep peroneal nerve 
sural nerve 
The tibial nerve is most prominent branch and can be blocked easily under ultrasound at the level of the medial malleolus. This nerve is often located posterior and lateral to the posterior tibial artery and medial to the flexor hallucis longus tendon. Anterior to the posterior tibial artery lie the tibialis posterior and flexor digitorum longus tendons. "



The superficial and deep peroneal nerves as well as the sural nerve are superficial in the subcutaneous tissue plane. The small deep peroneal nerve may be difficult to locate. This nerve is expected to lie adjacent to the anterior tibial vessels (above the ankle) and the dorsalis pedis artery (lower down at the ankle). 

Therefore the CPT would be 64450.  However, my question is if the blocks were placed at the deep peroneal, superficial peroneal and tibial nerves all on the right extremity, would I bill this as 64450 x3 or 64450, 64450-51,59 and 64450-51,59.

Thank you very much.


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## johnmeyer (Sep 1, 2013)

I would bill them out as follows, since they are three different locations all on the right side:

64450-RT
64450-59-RT
64450-59-RT


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## lch (Sep 4, 2013)

I agree w/ John.


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## suemt (Oct 4, 2013)

Thank you!  I'm always grateful when people post straightforward, useful information.


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