Outpatient Facility Coding Alert

Tip: Stay away from multiple codes.

Trigeminal neuralgia (also called tic douloureux) is a disorder of the trigeminal nerve. It causes severe facial pain that can be triggered by a light touch to the face or by movement of the facial muscles during eating or speaking. Trigeminal neuralgia may affect one or multiple divisions and/or branches of the trigeminal nerve. 

A trigeminal nerve block may be performed in a patient with trigeminal neuralgia in order to determine whether the patient will benefit from neurolysis. Read on to ensure that you’re coding these important procedures correctly.

Here’s How You Will Code

Code 64400 (Injection, anesthetic agent; trigeminal nerve, any division or branch) represents a nerve block of the trigeminal nerve, the gasserian ganglion, or any of the divisions or branches of the trigeminal. 

Take note: According to CPT® Assistant (December 2008), code 64400 “represents a single injection into a single nerve in the anatomy and sensory distribution of the peripheral trigeminal nerve.” Therefore, you should report one unit of code 64400 for each trigeminal nerve division or branch the provider blocks. For example, report two units of 64400 if the provider blocks both the supraorbital and infraorbital branches.