Neurosurgery Coding Alert
Focus on Muscle Vs Nerve for Piriformis Block
Question: We usually submit code 64445 for a piriformis nerve block, but the payer (Tricare) does not cover this code in an ASC. Our provider has asked if there is another code that would be appropriate or if code 64445 makes the best choice. Which of the two codes can we submit to the payer?
Georgia Subscriber
Answer: Code 64445 (Injection, anesthetic agent; sciatic nerve, single) describes a sciatic nerve injection. You should not use code 64445 to report a piriformis injection.
Nerve vs muscle: Anatomically speaking, the body does not have a piriformis nerve. That means the physician likely is performing a piriformis muscle injection, not a nerve injection. The correct choice instead for piriformis muscle injection(s) is 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscle[s]).
Earn for imaging guidance, if any: If your provider uses fluoroscopic guidance, you can report this in addition to the injection. Submit 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]).
Neurosurgery Coding Alert
- Procedure Focus:
Simplify Your Claims For Cranial Reconstruction Procedures
Removal, retrieval, and replacement of flap codes are as essential as primary procedure codes. Cranial [...] - Follow This 5 Step Guide for Cranial Bone Grafting Procedures
Cranial bone grafting may seem to be a coding challenge as there are multiple steps [...] - ICD-10 Focus:
ICD-10: Dig Deep Into Diabetic Neuropathy Diagnoses Codes
Focus on type of diabetes and neurological complications. A common diagnosis you may come across [...] - News:
Be On a Watch for ICD-10 Changes Later This Year
New codes, additions, and deletions will account for revisions in October. Prepare to see the [...] - E/M Coding:
Expert Answers For Your 5 Key Critical Care E/M Questions
Duration of care for critical illness or injury is important for 99291/99292. Critical care is [...] - You Be the Coder:
Fix All Levels in Spinal Fusion
Question: How can we report a posterior spinal fusion from L3 to T7? Our surgeon also [...] - Reader Question:
Focus on Muscle Vs Nerve for Piriformis Block
Question: We usually submit code 64445 for a piriformis nerve block, but the payer (Tricare) does [...] - Reader Question:
Check Primary and Secondary Closure in Wound Dehiscence
Question: Is repair of wound dehiscence ever payable during the global period? If so, does one [...]
