How To Use CPT Code 64448

CPT 64448 describes the continuous infusion of anesthetic agents and/or steroids into the femoral nerve using a catheter. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64448?

CPT 64448 is used to describe the continuous infusion of anesthetic agents and/or steroids into the femoral nerve using a catheter. This procedure involves placing a catheter near the femoral nerve and administering the medication through a continuous infusion. The femoral nerve is responsible for innervating the leg and foot, making this procedure effective for managing pain in those areas.

2. Official Description

The official description of CPT code 64448 is: ‘Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed.’ It is important to note that this code should not be reported in conjunction with codes 01996, 76942, 77002, or 77003.

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. A catheter is then placed near the femoral nerve using an insulated needle with a cannula.
3. The provider confirms the proper positioning of the needle and advances the cannula into the tissue around the femoral nerve.
4. Local anesthetic is injected through the cannula, and the catheter is threaded through the cannula.
5. The cannula is removed, and imaging guidance may be used to visualize the procedure.
6. The provider fixes the catheter in place, assesses the patient, and starts a continuous infusion of the anesthetic agent(s) and/or steroid.

4. Qualifying circumstances

CPT 64448 is typically performed on patients who require continuous infusion of anesthetic agents and/or steroids for pain management in the leg and foot. The procedure is suitable for patients with conditions that affect the femoral nerve, such as nerve damage, chronic pain, or post-operative pain. It is important to note that this procedure should not be reported with codes 01996, 76942, 77002, or 77003.

5. When to use CPT code 64448

CPT code 64448 should be used when a provider administers continuous infusion of anesthetic agents and/or steroids into the femoral nerve using a catheter. This code is appropriate for cases where the patient requires ongoing pain management in the leg and foot. It is important to follow the guidelines and not report this code with codes 01996, 76942, 77002, or 77003.

6. Documentation requirements

To support a claim for CPT 64448, the provider must document the following information:

• Patient’s diagnosis and the need for continuous infusion of anesthetic agents and/or steroids
• Details of the catheter placement procedure, including imaging guidance if performed
• Date and time of the procedure
• Specific anesthetic agents and/or steroids used
• Start and end time of the continuous infusion
• Assessment of the patient’s response to the infusion
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 64448, ensure that the procedure involves the continuous infusion of anesthetic agents and/or steroids into the femoral nerve using a catheter. It is important to follow the guidelines and not report this code with codes 01996, 76942, 77002, or 77003. Additionally, for bilateral procedures, report the appropriate bilateral code with modifier 50.

8. Historical information

CPT 64448 was added to the Current Procedural Terminology system on January 1, 2003. Since its addition, there have been several historical changes to the code, including updates to the description and code range.

9. Examples

1. A patient with chronic leg and foot pain undergoes continuous infusion of anesthetic agents and steroids into the femoral nerve using a catheter.
2. Following a surgical procedure on the leg, a patient requires ongoing pain management through the continuous infusion of anesthetic agents and steroids into the femoral nerve.
3. A patient with nerve damage in the leg and foot receives continuous infusion of anesthetic agents and steroids into the femoral nerve to alleviate pain.
4. After experiencing trauma to the leg, a patient undergoes continuous infusion of anesthetic agents and steroids into the femoral nerve to manage post-operative pain.
5. A patient with a chronic condition affecting the femoral nerve receives continuous infusion of anesthetic agents and steroids to alleviate pain in the leg and foot.