How To Use CPT Code 64447

CPT 64447 refers to the injection of anesthetic agents and/or steroids into the femoral nerve, including imaging guidance when performed. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 64447.

1. What is CPT 64447?

CPT 64447 is a medical procedure code used to describe the injection of one or more anesthetic agents and/or steroids into the femoral nerve area, which is responsible for innervating the leg and foot. This code is used when the provider performs one or more injections during a single procedure and may include imaging guidance for visualization purposes.

2. 64447 CPT code description

The official description of CPT code 64447 is: “Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed.”

3. Procedure

The 64447 procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider inserts a needle next to the femoral nerve and confirms the proper location.
3. Imaging guidance may be used to help visualize the procedure.
4. The provider administers one or more injections of one or more anesthetic agents and/or a steroid, based on the patient’s condition and needs.
5. The provider removes the needle.

4. Qualifying circumstances

Patients eligible to receive CPT code 64447 services are those who require anesthesia or pain relief in the area of the femoral nerve, which innervates the leg and foot. This may include patients undergoing surgical procedures, those with chronic pain conditions, or individuals experiencing acute pain due to injury or other causes.

5. When to use CPT code 64447

It is appropriate to bill the 64447 CPT code when a provider performs one or more injections of anesthetic agents and/or steroids into the femoral nerve area during a single procedure. This code should be used when the injections are intended to provide anesthesia or pain relief for the patient and may include imaging guidance for visualization purposes.

6. Documentation requirements

To support a claim for CPT 64447, the following information should be documented:

• Patient’s medical history and reason for the procedure
• Details of the procedure, including the number of injections and the type of anesthetic agents and/or steroids used
• Use of imaging guidance, if applicable
• Provider’s assessment of the patient’s response to the injections
• Any complications or adverse reactions experienced by the patient

7. Billing guidelines

When billing for CPT code 64447, it is important to follow the appropriate guidelines and rules. Do not report 64447 in conjunction with 01996, 76942, 77002, or 77003. For bilateral procedures, report the relevant codes with modifier 50. Additionally, for continuous infusion of an anesthetic and/or steroid via catheter for the femoral nerve, use CPT code 64448 instead.

8. Historical information

CPT 64447 was added to the Current Procedural Terminology system on January 1, 2003. The code has undergone changes in its descriptor over the years, with the most recent change occurring on January 1, 2023.

9. Similar codes to CPT 64447

Five similar codes to CPT 64447 and how they differentiate are:

1. CPT 64448: This code is used for continuous infusion of an anesthetic and/or steroid via catheter for the femoral nerve, as opposed to single or multiple injections.
2. CPT 64449: This code is used for injections of anesthetic agents and/or steroids into the lumbar plexus, rather than the femoral nerve.
3. CPT 64450: This code is used for injections of anesthetic agents and/or steroids into other peripheral nerves or branches, not the femoral nerve.
4. CPT 64455: This code is used for injections of anesthetic agents and/or steroids into the plantar common digital nerve(s), not the femoral nerve.
5. CPT 64479: This code is used for injections of anesthetic agents and/or steroids into the paravertebral facet joint, not the femoral nerve.

10. Examples

Here are 10 detailed examples of CPT code 64447 procedures:

1. A patient undergoing knee surgery requires anesthesia in the femoral nerve area. The provider performs a single injection with imaging guidance.
2. A patient with chronic pain in the leg due to nerve damage receives a series of injections of anesthetic agents and steroids into the femoral nerve for pain relief.
3. A patient experiencing acute pain from a leg injury requires multiple injections of anesthetic agents and steroids into the femoral nerve for pain management.
4. A patient undergoing hip surgery requires anesthesia in the femoral nerve area. The provider performs multiple injections with imaging guidance.
5. A patient with a history of chronic pain in the leg due to nerve damage receives a single injection of anesthetic agents and steroids into the femoral nerve for pain relief.
6. A patient experiencing acute pain from a hip injury requires a single injection of anesthetic agents and steroids into the femoral nerve for pain management.
7. A patient undergoing a surgical procedure on the leg requires anesthesia in the femoral nerve area. The provider performs a single injection without imaging guidance.
8. A patient with chronic pain in the leg due to nerve damage receives multiple injections of anesthetic agents and steroids into the femoral nerve for pain relief, with imaging guidance used for visualization.
9. A patient experiencing acute pain from a leg injury requires multiple injections of anesthetic agents and steroids into the femoral nerve for pain management, with imaging guidance used for visualization.
10. A patient undergoing a surgical procedure on the hip requires anesthesia in the femoral nerve area. The provider performs multiple injections with imaging guidance.