How To Use CPT Code 64435

CPT 64435 describes the injection of an anesthetic agent, steroid, or both in the paracervical or uterine nerve in females. 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 64435?

CPT 64435 can be used to describe the injection of an anesthetic agent, steroid, or both in the paracervical or uterine nerve in females. This code is used when the provider administers one or more injections close to the uterine or paracervical nerve to provide analgesia during gynecological procedures or to relieve pain during labor.

2. Official Description

The official description of CPT code 64435 is: ‘Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve.’

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, steroid, or both close to the uterine or paracervical nerve.
3. The injections anesthetize the areas around the nerve, providing pain relief during gynecological procedures or labor.
4. The provider may also perform this procedure for diagnostic purposes.

4. Qualifying circumstances

CPT 64435 is performed on female patients and is typically used to provide analgesia during gynecological procedures involving cervical dilation or to relieve pain from uterine contraction and cervical stretching during the early stages of labor. The injections are administered close to the uterine or paracervical nerve, which is a network of nerves lying in the tissues surrounding the cervix.

5. When to use CPT code 64435

CPT code 64435 should be used when the provider administers one or more injections of an anesthetic agent, steroid, or both in the paracervical or uterine nerve of a female patient. This code is appropriate for gynecological procedures involving cervical dilation or for pain relief during the early stages of labor.

6. Documentation requirements

To support a claim for CPT 64435, the provider must document the following information:

• Reason for the procedure and the need for analgesia
• Number of injections administered
• Specific anesthetic agent, steroid, or combination used
• Date and time of the procedure
• Any additional relevant information, such as diagnostic purposes
• Provider’s signature

7. Billing guidelines

When billing for CPT 64435, ensure that the procedure is performed on a female patient and involves the injection of an anesthetic agent, steroid, or both in the paracervical or uterine nerve. There are no specific guidelines regarding reporting this code with other codes. However, it is important to follow any applicable modifier requirements and to accurately document the procedure to support the claim.

8. Historical information

CPT 64435 was added to the Current Procedural Terminology system on January 1, 1990. The code was last updated on January 1, 2020, with a change in the description to specify the injection of anesthetic agent in the paracervical (uterine) nerve.

9. Examples

1. A provider administers an injection of an anesthetic agent in the paracervical nerve to provide pain relief during a gynecological procedure.
2. A patient in labor receives an injection of a steroid in the uterine nerve to alleviate pain from uterine contractions.
3. A provider performs a diagnostic injection of an anesthetic agent in the paracervical nerve to determine the source of a patient’s pelvic pain.
4. An individual undergoing cervical dilation for a gynecological procedure receives an injection of an anesthetic agent in the paracervical nerve for analgesia.
5. A provider administers an injection of an anesthetic agent and steroid in the uterine nerve to provide pain relief during the early stages of labor.
6. A patient with a history of painful gynecological procedures receives an injection of an anesthetic agent in the paracervical nerve prior to the procedure.
7. A provider performs a paracervical nerve block using an anesthetic agent and steroid to provide pain relief during a hysteroscopy.
8. An individual in labor receives multiple injections of an anesthetic agent in the uterine nerve to manage pain during contractions.
9. A provider administers an injection of a steroid in the paracervical nerve to alleviate pain from cervical stretching during the early stages of labor.
10. A patient undergoing a gynecological procedure receives an injection of an anesthetic agent and steroid in the paracervical nerve for analgesia.