CPT 64450, 64450, cpt code 64450, 64450 cpt code

CPT 64450 | Description, Guidelines, Reimbursement, Modifier & Examples

CPT 64450 can be reported for introducing/injecting an anesthetic medication (nerve block), diagnostic, or treatments on the somatic nervous system. Enter this code to receive an injection in a single action. An anesthetic, steroid, or both injections should give to a peripheral nerve.

Some instances include post-herniorrhaphy discomfort, iliac crest harvest syndromes, Morton’s neuromas, and carpal tunnel syndrome. By employing Peripheral Nerve Blocks (PNBs), anesthesiologists can treat patients safely and successfully without medications. 

Individuals suffering from prolonged post-herniorrhaphy pain may benefit from using PNBs instead of more invasive procedures (e.g., surgery), according to the medical reimbursement than where it can bill for and CTP code 64450 operations such as nerve blocks.

The most recent CPT codes in this industry and their relative value must consider while attempting to reduce claim denials and boost compensation.

CPT codes 64400 to 64530 can be used for postoperative pain management. Medicare First Coast Service Options, Inc. claims this. It can use for the following.  

  • PNBs can use both diagnostically and therapeutically.
  • In rare circumstances, doctors can use a PNB to diagnose the exact cause of discomfort.
  • PNBs for therapeutic purposes can employ in a variety of ways. 

The most recent CPT 64450 can use in this industry, and their relative value must consider while attempting to reduce claim denials and boost compensation. Ultrasonography can use to locate the injection site for nerve blocks precisely. PNBs can classify into three types:

  • Thigh and foot swelling
  • Obstructions of the thoracic and abdominal nerves that affect the upper limbs

PNBs can use to treat acute pain either intravenously or constantly through catheterization. PNBs must incorporate into the patient’s therapy regimen to properly treat chronic pain. When a procedure is medically required, the clinician must determine the optimum location for care. 

You must know payer requirements to submit accurate claims and receive total compensation. They must also include the appropriate modifiers, fees, and codes. Peripheral nerve blocks (single or continuous injections) can only use to treat chronic pain as part of a multi-pronged pain treatment strategy. Something more should require for acute pain.

Peripheral nerve blocks are utilized after a hemorrhage to relieve chronic pain without turning to more invasive therapies (e.g., surgery). The nerve block injection can also use for the following purpose.

  • Chronic pain can only be relieved by peripheral nerve blocks.
  • Use of peripheral nerve blocks regularly to treat non-debilitating, persistent symptoms.

CPT 64400 – CPT 64530 denote peripheral nerve blockades. Nerve blocks can code as CPT codes 64450. A single injection or a continuous infusion can use to block peripheral nerves.

Peripheral Nerve Block (PNB) is a safe and efficient treatment option for elderly persons suffering from headaches. According to Beers, medical and psychological co-morbidities were also high, indicating that peripherally delivered drugs may be more effective and well-tolerated by the senior population.

64450 CPT Code Description

CPT’s manual describes CPT 64450 as: “Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch.”

In the recent decade, there has been a tremendous shift in how nerve blocks can use to treat severe pain.

As a result, block methods and techniques have become more prominent in orthopedic surgery, and surgeons have responded by refining their processes and procedures. 

The well-known CPT coding reference standard has approved many different permutations of this issue. Most healthcare professionals use one of three essential codes.

These blocks can pay from a surgical fee schedule instead of anesthetic services, which can settle in ASA units. The sciatic and adductor canals’ femoral and popliteal blocks are available for purchase.

Before 2013, TAP blocks could perform in a single direction with a single shot. Three years later, four more codes could devise to represent four alternative TAP block configurations: (64486, 64487, 64488, and 64489). Each of these new codes now contains USG, which was previously charged individually for previous blocks.

Peripheral nerve blocks (PNB) can commonly provide postoperative and nonsurgical analgesia and surgical anesthesia. In some therapeutic conditions, PNBs are superior to general or neuraxial anesthesia. Furthermore, PNBs can produce analgesia superior to conventional treatments for certain persons.

Peripheral nerve blocks can help patients with various diseases (PNBs). In addition, using blocks can reduce the need for additional anesthesia or analgesics in various situations.

Two of the most prominent arguments for its use are general anesthetic adverse effects, notably respiratory ones, and the desire to use fewer opioids while still providing analgesia.

In the postoperative analgesia program, it is a crucial component and can treat posterior knee pain following surgical repair. The anterior nerve and the medial part of the lower spine are to blame for this discomfort.

A sciatic nerve block can relieve pain in the back of the knee. Still, it can also postpone the detection and treatment of medically induced common peroneal nerve injury, which can be fatal.

The sciatic nerve block could replace with a targeted tibial nerve block in the posterior aspect. Furthermore, it reduces plantar flexion and the ability to feel sensations in the sole.

As the number of blocks increases, the coding team receives information about blocks that CPT has not accepted. As a result, many people suffer from IPACK (popliteal artery infiltration into the knee capsule) or erector spinal blockages, which could cause fatal.

Billing Guidelines

CPT 64400 – CPT 64530 describes anesthetic medication injections for diagnostic or therapeutic purposes. A single unit of service during patient contact includes all injections into the nerve, including any branches recognized (identified) by the code descriptor (UOS). 

Can CPT 64450 Be Billed Multiple Times?

If a practitioner administers an anesthetic agent to multiple locations near the sciatic nerve during a single patient visit, only one UOS of CPT code 64445 (injection, anesthetic agent; sciatic nerve, single) must report.

If a physician injects the superior medial and lateral branches, inferior medial and lateral branches, and lateral branches of the left genicular nerve, CPT code 64450 (Injection, anesthetic medication; other peripheral nerve or branch) could record once.

Even if a single nerve plexus, nerve, or branch receives many injections, only one injection code must report for each treatment. In contrast, the CPT differentiates between categories that require graphical advice and those that could write independently. 

If completed and documented, imaging instructions for CPT 64400 – CPT 64450 could report individually. Regulations can now charge according to the number of units and whether or not imaging guidance could provide in the code description.

The CTP list consists of anesthetic agents and steroids. Since injections of the face, phrenic, and cervical plexuses can rarely perform, codes 64402, 64410, and 64413 would eliminate. CPT recommends reporting the use of the unlisted CPT code 64499.

CPT code 64450 can be used for radiofrequency ablation of the SI nerves. This code cannot use to record chemodenervation (CPT 77002, 77003, 77012) or radiological guidance (CPT 77002, 77003, 77012). (CPT 95873, 95874). When two surgeries would conduct at the same time, Modifier 50 must utilize.

The injection of the gingival nerve now has its CPT code (CPT 64454). According to the parenthetical instruction, superolateral and inferolateral nerve branches must inject. If not all three nerve branches inject, modifier 52 (reduced services) should assign to the CPT 64454.

Only one unit of service must report. CPT code 64624, which represents nerve injury, should not be used in conjunction with these codes. When genicular nerve branches are severed, they designate as 64624. 

In today’s ever-changing billing and a coding environment, peripheral nerve blocks may be challenging to charge and code. Working with an experienced medical billing company allows pain management treatment providers to stay updated on coding and billing standards changes.

Does CPT Code 64450 Need A Modifier?

CTP code 64450 could administer independently on the same day as the anesthesia. Modifier 59 must add CTP code 64450 in this case. Use modifier 52 if the injection code (CPT 64450) does not reflect injury to all nerve branches.

Patients undergoing general or spinal anesthesia or regional anesthesia through epidural injection must give epidural or peripheral nerve block injections. Therefore, distinct Procedural Service modifier 59 is one of the most potent modifiers in the CPT code set. 

It can use claims to demonstrate that two different and unique operations will carry out simultaneously. Each is self-contained and entitled to total remuneration. It is the only option when all other modifiers fail to describe a particular event adequately.

Three nerve branches must destroy, imaging guidance must employ, and just one unit of service, much like the injection code, must be documented.

If nerve blocks perform to treat postoperative discomfort, the CPT code (Nerve blocks) could record on the day of operation. No need to categorize nerve blocks differently if used as a primary anesthetic treatment or as a backup for surgical procedures. 

Instead of intraoperative anesthesia, a nerve block injection for postoperative pain management must advise with modifier 59, which should document in the patient’s medical record as a procedural note.


Private payer payments for CPT 64450 might range from as little as $100 per treatment to nothing. Don’t assume that every Blue Cross insurance, for example, provides the same block coverage for these blocks as a general rule.


A 65-year-old patient will find to have migraine symptoms. The Peripheral nerve blocks are extensively utilized in this demographic as an acute and short-term headache treatment and may be a safer option than standard medication.

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