Anesthesia Coding Alert

Question: A co-worker and I disagree over the correct code for a piriformis injection. I thought we could use 64445, but she says no. What's the right code?

New Jersey Subscriber

Answer: The December 2011 issue of CPT® Assistant clarified that code 64445 (Injection, anesthetic agent; sciatic nerve, single) does not apply to piriformis muscle injections, in an article about reporting piriformis and sciatic nerve injections.

The better choice for piriformis injection is 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscle[s]). If the provider uses fluoroscopic guidance, also report 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]).