Wiki diagnosis for 64445?

tracibarnes

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I have been billing this code out for a while now and recently BC/Regence is denying it for "diagnosis is inconsistent for procedure" Is there a list somewhere of accepted diagnosis codes to bill with this procedure? I have used Lesion of Sciatic Nerve... G57.01 or G57.02 or G5700 but it's still denying for this.
 
64445 is a nerve block of the sciatic nerve that is usually performed for pain management (ie, post-traumatic, post-operative). As an anesthesia coder, I code that with G89.18, when it's documented for post-operative pain management. That said, what is the diagnosis documented in the note explaining why is 64445 being performed, and who is performing this service?

On a side note, we may only code what is documented.
 
64445 is a nerve block of the sciatic nerve that is usually performed for pain management (ie, post-traumatic, post-operative). As an anesthesia coder, I code that with G89.18, when it's documented for post-operative pain management. That said, what is the diagnosis documented in the note explaining why is 64445 being performed, and who is performing this service?

On a side note, we may only code what is documented.
The doctor is doing this nerve block for Sciatica on the right side that is also causing hamstring pain. It is not post procedural. I will add the hamstring pain to the claim.
 
I did that on the initial claim and it denied for the" diagnosis inconsistent for this procedure." I'm not sure what they want here. Blue Cross has been doing this a lot lately. So frustrating...
I would have to see the op note to be sure then.
 
I did that on the initial claim and it denied for the" diagnosis inconsistent for this procedure." I'm not sure what they want here. Blue Cross has been doing this a lot lately. So frustrating...
My guess on this is a payor policy. There are a lot of different Blues and not all follow the same policies. I did find this for BCBS of FL and the policy was just updated a month ago:
 
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