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Orthopedic Coding Alert

Reader Question:

Lidocaine for Peroneal Sural Nerve Block

Published on Thu Aug 01, 2002

Question: Our orthopedist documented a left peroneal sural nerve block. He indicates that he used lidocaine for temporary relief of the patient's pain. Which CPT code should I use to report this? Pennsylvania Subscriber Answer: Code the injection using 64450* (Injection, anesthetic agent; other peripheral nerve or branch), but do not bill separately for the lidocaine (J2000). Medicare will not accept claims for this drug when billed with any ICD-9 code other than those related to cardiac arrhythmias and emergencies. For example, Georgia Medicare's policy for lidocaine states, "The dosage indicated by the code description is specific to the treatment of cardiac arrhythmias and emergencies only. The billing of J2000 is not appropriate for the 1-2 cc usually required for a local anesthetic."  
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