# 64455 for Morton's neuroma



## goldkapp (Jul 8, 2009)

64455 is the new code for Morton's neuroma injections. Can we only bill that code once no matter how many neuromas are injected?


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## Anna Weaver (Jul 9, 2009)

*64455*

I have a note on that code that says x1 no matter the number of nerves. I will see if I can find where I got that info.


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## Anna Weaver (Jul 9, 2009)

*64455*

I found where I got the information. A teleconference by AAPC on procedural codes 2009 CPT changes I believe it was in November 2008. It's listed under neurology and it says:

"This injection is performed for Morton's neuroma, a painful condition that develops secondary to repetitive stress or trauma. Morton's neuroma occurs in the space between the toes and is commonly treated with steroid injection.
An injection of lidocaine or bupivacaine is sometimes employed to confirm the diagnosis of Morton's neuroma and provide the patient temporary relief. Code 64455 is reported once per encounter, even if more than one injection is given."

So, I marked in my book to use only one time no matter the number of injections per encounter.

Hope this helps.


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## RebeccaWoodward* (Jul 9, 2009)

Anna,

This is an excerpt from CPT Assistant.  It almost sounds as if if the procedure was performed for each foot, you could charge once, for each side.  Any thoughts?

"Code 64455, Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton's neuroma), which was introduced in the CPT 2009, specifically represents injection of an anesthetic agent and/or steroidal agent into the involved plantar digital nerve interspace. Code 64455 is *reported only once per foot*, regardless of the number of injections provided, as is reflected in the plural forms for "injection" and "nerve."

(1-09, Vol 19, Issue 1)


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## Anna Weaver (Jul 9, 2009)

*64455*



rebeccawoodward said:


> Anna,
> 
> This is an excerpt from CPT Assistant.  It almost sounds as if if the procedure was performed for each foot, you could charge once, for each side.  Any thoughts?
> 
> ...




Rebecca,
I would agree with once per foot. I think that's what they are referring to in my notes, although it's not stated that way (gotta remember this was in Nov 08 and a new code for Jan 09). It just says once per session, and I'm glad CPT assistant clarified! Thanks for pointing this out! 
Gotta love this site!!! I learn so much.


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## caprigrl (Aug 31, 2009)

*Question*

How many times can a patient get an injection 64455 before it is global per Medicare guidelines?

Thank you


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## RebeccaWoodward* (Sep 1, 2009)

64455 has zero (0) global days


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## TammyHF (Sep 14, 2009)

According to the LCD for J5 MAC Part B the limit is three injections. After three injections the physician would have to submit medical documentation to show medical necessity for additional 64455 injections.


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