Wiki Sclerosing injections-need help

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Acctcoder

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Need to know what DPM offices are coding for CPT for sclerosing injections for Sural Nerve pain/neuritis.... here is a paraphrasing of 1 of approx 200 actual office visit/sclerosing injections note paraphrased:

F/U care for Left Foot painful Sural neuritis and neuropathy with callus formation and painful scar on the lateral aspect of the 5th metatarsal head as well as plantarly. Pt is status post open fracture metatarsal from 5/19/1998

Sclerosing injection was given placed more proximally at the point of maximal tenderness to the Plantar Sural Nerve aspect on the LF 5th metatarsal head. 1 cc was injected. (note recent notes do not indicate substance injected but Provider has stated was an Alcohol sclerosing solution perhaps Alcohol & Epinephrine per one old review).

CPT's being considered are: 64450, 64455, 64632 & 64640. Please let me know especially if you have any Poidiatry-specific journals, etc beside AMA CPT. Thanks!
 
64640 - Destruction by neurolytic agent: other peripheral nerve or branch

The descriptions/definitions of all of those injections you mentioned are in the CPT book as well as the Coding Companion for Podiatry.
 
solocoder - thank you for your reply.... but I'm wondering...

The 64640 is a destruction CPT and given the Guideline notes before that CPT section state "do not code destruction if target nerve not destroyed". In this particular patient, they have received over 200 of these same (weekly) injections of Absolute alcohol solution and still claim symptoms of pain in same area so nerve must not be permanently destroyed, right? As well as there must be a limitation to the number of "destruction" injections a provider can give, right?

The 64455 injection CPT describes non-destructive injection better doesn't it?
 
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