How To Use CPT Code 64445

CPT 64445 describes the injection of anesthetic agents and/or steroids into the sciatic nerve, with the use of imaging guidance if necessary. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64445?

CPT 64445 can be used to describe the injection of anesthetic agents and/or steroids into the sciatic nerve. This code is used when the provider administers one or more injections during a single procedure.

2. Official Description

The official description of CPT code 64445 is: ‘Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed.’

3. Procedure

1. The provider prepares the patient and administers one or more injections of anesthetic agents and/or steroids into the area of the sciatic nerve.
2. If necessary, the provider may use imaging guidance to assist in visualizing the procedure.
3. The provider takes care to avoid direct injury to the sciatic nerve with the needle.
4. After the injections are administered, the provider removes the needle.

4. Qualifying circumstances

CPT 64445 is used for patients who require injections of anesthetic agents and/or steroids into the sciatic nerve. This procedure may be performed for diagnostic or therapeutic purposes. It is important to note that CPT code 64445 should not be reported in conjunction with codes 76942, 77002, or 77003.

5. When to use CPT code 64445

CPT code 64445 should be used when the provider administers one or more injections of anesthetic agents and/or steroids into the sciatic nerve. This code is appropriate for both diagnostic and therapeutic procedures.

6. Documentation requirements

To support a claim for CPT 64445, the provider must document the following information:

• The need for the injections and the patient’s condition
• The specific anesthetic agents and/or steroids used
• The date and time of the procedure
• Any imaging guidance used, if applicable
• The number of injections administered
• The location of the injections
• Any complications or adverse reactions
• The provider’s signature

7. Billing guidelines

When billing for CPT 64445, ensure that the injections are performed into the sciatic nerve and that imaging guidance, if used, is documented. Do not report CPT 64445 in conjunction with codes 76942, 77002, or 77003. For bilateral procedures, use the appropriate bilateral modifier. It is important to note that CPT code 64445 has historical changes, so be sure to use the most up-to-date code description.

8. Historical information

CPT 64445 was added to the Current Procedural Terminology system on January 1, 1990. There have been several code changes since its addition, including updates to the code description and the addition of imaging guidance as a component of the procedure.

9. Examples

1. A patient with sciatica receives an injection of anesthetic agents into the sciatic nerve to alleviate pain.
2. A provider uses imaging guidance to administer a steroid injection into the sciatic nerve of a patient with chronic inflammation.
3. During a diagnostic procedure, the provider administers an anesthetic agent into the sciatic nerve to determine the source of the patient’s leg pain.
4. A patient with sciatic nerve entrapment undergoes a therapeutic procedure involving the injection of both anesthetic agents and steroids.
5. A provider performs a series of injections into the sciatic nerve to manage the symptoms of a patient with neuropathy.