Wiki Nerve Blocks 64400

[shanamarie]

I need some clarification on billing for Trigeminal nerve blocks. In reading the description it states Injection trigeminal nerve, each branch. Can bill as bilateral if both sides are injected. There are 3 branches in the trigeminal nerve; ophthalmic, maxillary and mandibular. If a provider injects the supraorbital and supratrochlear which are part of the ophthalmic nerve branch, would this just count as 1 injection (64400) if done unilateral since they are both part of the ophthalmic branch? That's the way I'm interpreting this, but I have a provider questioning this and stating it should be 64400x2.

Also can anyone provide guidance on what code you would use for preauricular? I have this listed as 64450.

 

[jkyles]

Hi there, you are correct. You can show your provider the guidelines for nerve blocks in your CPT manual (emphasis added):

Codes 64400-64450, 64454 describe the injection of an anesthetic agent(s) and/or steroid into a nerve plexus, nerve, or branch. These codes are reported once per nerve plexus, nerve, or branch as described in the descriptor regardless of the number of injections performed along the nerve plexus, nerve, or branch described by the code.