How To Use CPT Code 64425

CPT 64425 describes the injection of an anesthetic agent and/or steroid near the ilioinguinal or iliohypogastric nerves. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64425?

CPT 64425 can be used to describe the injection of an anesthetic agent and/or steroid near the ilioinguinal or iliohypogastric nerves. This code is used when the provider administers one or more injections to anesthetize the areas below these nerves. It is commonly performed for primary anesthesia or pain control after lower abdominal surgery and inguinal hernia repair, as well as for diagnostic purposes.

2. Official Description

The official description of CPT code 64425 is: ‘Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves.’

3. Procedure

1. The provider prepares the patient for the procedure.
2. Using a needle and syringe, the provider administers one or more injections of an anesthetic agent and/or steroid near the ilioinguinal or iliohypogastric nerves.
3. The injections anesthetize the areas below these nerves, providing pain relief or anesthesia.
4. The provider may perform this procedure for primary anesthesia or pain control after lower abdominal surgery and inguinal hernia repair, as well as for diagnostic purposes.

4. Qualifying circumstances

CPT 64425 is performed when the patient requires anesthesia or pain control after lower abdominal surgery and inguinal hernia repair. It may also be performed for diagnostic purposes. The injections are administered near the ilioinguinal or iliohypogastric nerves, which supply the lower abdominal wall, upper-middle thigh, and parts of the male and female genitalia.

5. When to use CPT code 64425

CPT code 64425 should be used when the provider administers one or more injections of an anesthetic agent and/or steroid near the ilioinguinal or iliohypogastric nerves. It is appropriate for primary anesthesia or pain control after lower abdominal surgery and inguinal hernia repair, as well as for diagnostic purposes.

6. Documentation requirements

To support a claim for CPT 64425, the provider must document the following information:

• Reason for the procedure, such as lower abdominal surgery, inguinal hernia repair, or diagnostic purposes
• Number of injections administered
• Type of anesthetic agent and/or steroid used
• Date and time of the procedure
• Areas anesthetized by the injections
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 64425, ensure that the injections are administered near the ilioinguinal or iliohypogastric nerves. Use modifier 50 for bilateral procedures. Do not report CPT 64425 if it has been performed with other codes in the previous seven days. Be aware of the appropriate use of modifiers and consider the location of the injections when coding.

8. Historical information

CPT 64425 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2020, with a revised description.

9. Examples

1. A patient undergoes lower abdominal surgery and receives an injection near the ilioinguinal nerve for pain control.
2. A provider administers an injection near the iliohypogastric nerve to anesthetize the area during an inguinal hernia repair.
3. A diagnostic procedure requires the provider to administer an injection near the ilioinguinal and iliohypogastric nerves to assess the source of the patient’s pain.
4. After lower abdominal surgery, the provider administers multiple injections near the iliohypogastric nerve to ensure effective pain control.
5. A patient with chronic pelvic pain receives an injection near the ilioinguinal nerve to alleviate their symptoms.
6. During a diagnostic procedure, the provider administers an injection near the iliohypogastric nerve to determine the cause of the patient’s abdominal discomfort.
7. For pain management after inguinal hernia repair, the provider administers an injection near the ilioinguinal nerve to provide localized anesthesia.
8. A patient undergoing lower abdominal surgery receives an injection near the iliohypogastric nerve to ensure postoperative pain control.
9. A diagnostic procedure requires the provider to administer multiple injections near the ilioinguinal and iliohypogastric nerves to accurately diagnose the patient’s condition.
10. During an inguinal hernia repair, the provider administers an injection near the ilioinguinal nerve to provide pain relief during the procedure.