Anesthesia Coding Alert

Question: The CPT code for a sciatic nerve block is CPT 64445* (Injection, anesthetic agent; sciatic nerve). Should one presume that this is a block done at the hip? What about a popliteal block, in which the sciatic nerve is blocked at the popliteal fossa? How should this be coded?

North Dakota Subscriber

Answer: The sciatic nerve divides into the tibial and common peroneal nerves at the lower third of the thigh. When an injection is done in the popliteal fossa space, the provider should indicate what structure he or she is trying to block. If the block is for the peroneal or tibial nerve, the appropriate code is 64450* (Injection, anesthetic agent; other peripheral nerve or branch).

Does the sciatic nerve need to be blocked only at the hip? The answer is no. The CPT code is not specific as to location along the sciatic nerve, only that it is the anatomic structure that is being blocked. The hip is the most frequent location.