Cpt code 64420 10 – M79. Injections to include both the plantar fascia and the area around a calcaneal spur, are to be reported using only CPT code 20551 with a unit of service of 64420 is the primary code and 64421 is an add on code for each additional level beyond the first level represented by 64420 so modifier 59 would not be appropriate on either code. Jan 1, 2020 · For services provided on and after January 1, 2020, CPT code 64421 is considered an add-on code. Refer to LCD L33930 Facet Joint Interventions for Pain Management for information regarding billing paravertebral facet joint blocks on the same date of service. 52 : $69. 64420 Injection(s), anesthetic agent(s) and/or steroid Oct 1, 2015 · Added the statement "Effective 01/01/2020, 64999 is to be used to report injections of anesthetic and/or steroids for the facial and phrenic nerves and cervical plexus. Oct 1, 2015 · All the ICD-10-CM codes listed below DO NOT support medical necessity and will deny when billing 64450 WITH 76881, 76882, 76942, 76999, 97032, 97139, G0282 and/or G0283 (above Group 2 CPT codes) for peripheral nerve blocks (including G57. CPT code 64420 represents a medical procedure involving the injection of anesthetic agents and/or steroids into the intercostal nerve at a single level. 8, G58. On a CPT ® code's hierarchy page, you get to see a medical code's neighbors On a CPT ® code's hierarchy page, Feb 8, 2019 · Femoral Nerve Blocks, use CPT Code 64447, Intercosta Nerve Block, use CPT Code 64420, 64421 64447 Injection of anesthetic agent; femoral nerve, single Common ICD-10 Cross Over: 64420 : Injection, anesthetic agent; intercostal nerve, single . 7, G58. New codes are also added to report destruction of the genicular nerves and radiofrequency ablation of the sacroiliac joint. In 2019, the submission of a transaction/claim for intercostal nerve injection services would have included either CPT 64420 (a single nerve injection) or 64421 (multiple nerve injections). Effective January 1, 2020, CPT® code 64421 became an add on code to be reported in conjunction with code 64420: Codes in 2019 . Feb 18, 2020 · The insurance, UHC Medicare, denied pmt on 64420. 91, G57. Coders are now instructed to report 64420 for the first level and 64421 for each additional level injected. The intercostal nerves are vital components of the thoracic spinal nerve system, responsible for sensory and motor functions in the chest area. CPT Code 64420. I understand that 76942 and 77003 are mutual exclusive. In this scenario, the primary code is CPT 64420: “Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level. It is important to report this code in conjunction with the primary code, which is 64220 , for the initial intercostal nerve injection. Jun 7, 2017 · The plural form of the code descriptor for CPT 64421 would support that it encompasses multiple nerves being treated; whereas, CPT 64420 has intercostal nerve in the singular. 92, G58. 2: Vaginismus: R10. 64420 Injection, anesthetic agent; intercostal nerve, single. 64420 : Injection, anesthetic agent; intercostal nerve, single . CPT codes not covered for indications listed in the CPB: Posterior femoral cutaneous nerve block –no specific code: ICD-10 codes not covered for indications listed in the CPB (not all inclusive): M79. I know 59 would not be appropriate because it's not a distinct procedure and the CPT code book states to use 64421 in conjunction with 64420 what multiple nerves are injected. 18: Myalgia: N94. 64413 Injection, anesthetic agent; cervical plexus – to report use CPT Jun 18, 2024 · Report the right codes – The right CPT and HCPCS codes and modifiers provide information about the service and how it was performed. 64420, 64421, 64425, 64430, 64445, 64450, 64451, Note: Only IPM codes were shown in Column 1 2. I looked up the NCCI edit and it states that 64420 is a column 2 code for 64421. If a single injection is given at T3 to treat 1 nerve , and 3 nerves on other levels from T4 to T9, then code 64420, 64421*3? Any guidance is much appreciated Aug 10, 2023 · Code 64421: An Add-on Code. In the CPT book, it does not indicate fluoroscopic guidance (77003) is included in cpt code 64400 - 64450. The MUE might be available of 3 to support if the patient is in the hospital and in separate encounters on the same day the procedure has to be repeated. 59 : $60. Insurance company/Medicare always denies payment on this combination. 64421 . CPT Code 64430. This includes code additions, deletions and revisions to existing codes and the introductory guidelines. Refer to the Coverage and Limitations section above. Here’s the key – 64421 is an add-on code, meaning it’s always used in conjunction with a primary code. ” CPT 2020 makes significant changes to the family of codes for Somatic Nerve Injections (CPT 64400-64489). The Current Procedural Terminology (CPT ®) code 64420 as maintained by American Medical Association, is a medical procedural code under the range - Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic or Therapeutic Procedures on the Somatic Nerves. This code replaces the deleted codes 64402, 64410 and 64413" to the Group 1 Paragraph and added 64999 to the list of Group 1 Codes in the CPT/HCPCS Codes section. This article includes ICD-10 Crossover Codes, Global Periods, Imaging Guidance, Modifiers, Utilization Guidelines, Bundling/Unbundling, and Insurance Payer Policies. When we code it with ultrasound guidance (76942), insurance always pays for it. My question is what modifier to use. Feb 1, 2023 · In recent years, these codes have been frequently reported with imaging (CPT code 76942 using codes 64405, 64408, 64420, 64421, 64425, 64430, 64435, and 64449 Femoral Nerve Blocks, use CPT Code 64447, Intercosta Nerve Block, use CPT Code 64420, 64421 64447 Injection of anesthetic agent; femoral nerve, single Common ICD-10 Cross Over: Dec 9, 2021 · I want to understand these codes. Apr 1, 2025 · 64420 - CPT® Code in category: Injection(s), anesthetic agent(s) and/or steroid; CPT Code information is available to subscribers and includes the CPT code number Injections for plantar fasciitis are addressed by CPT code 20550, not CPT code 64450. Refer to the National Correct Coding Initiative Policy Manual for Medicare Services, Chapter 2 and Chapter 8 for CPT codes 64400-64530 coding instructions. Deleted codes: 64402 Injection, anesthetic agent; facial nerve – to report use CPT code 64999. CPT Code CPT Code Descriptor Physician at Facility Payment ASC Payment 64415 View the CPT® code's corresponding procedural code and DRG. It appears this was not communicated to NCCI, as the 1/1/2020 edits still bundle 64420 into 64421. 37 . $113. CPT 64420 describes injecting anesthetic agents and/or steroids into a single intercostal nerve. 2). *This response is based on the best information available as of 06/28/18. CPT Code CPT Code Descriptor Professional Payment APC Code APC Payment 76942 . 9 G59, M54. 20 . 64425 . CPT Code 64425. $102. Codes in 2020. Injections for calcaneal spurs are addressed as are other tendon origin/insertions by CPT code 20551. (Per Codify there ar Jun 28, 2018 · No you should report 64421 (Injection, anesthetic agent; intercostal nerves, multiple, regional blocks). Jul 8, 2011 · Please enlighten me here. 76461"] That does help - I wish I could find something saying 64420 is not appropriate for an We would like to show you a description here but the site won’t allow us. 64421 Injection, anesthetic agent; intercostal nerves, multiple, regional block. 64410 Injection, anesthetic agent; facial nerve – to report use CPT code 64999. CPT 64425 describes injecting anesthetic agents and/or steroids into the ilioinguinal and iliohypogastric nerves. CPT code 64420 is used for a single injection and CPT 64421 is reported for multiple intercostal nerve blocks even when the injections are at three levels. CPT 64430 describes injecting anesthetic agents and/or steroids into the pudendal nerve Jan 1, 2006 · 02-61000-29 Original Effective Date: 11/15/00 Reviewed: 01/23/25 Revised: 03/15/25 Subject: Nerve Block Injections THIS MEDICAL COVERAGE GUIDELINE IS NOT AN AUTHORIZATION, CERTIFICATION, EXPLANATION OF BENEFITS, OR A Aug 31, 2024 · You can Learn Billing and Coding Peripheral Nerve Block CPT 64450, 64405, 64420, 64447, 64418. 64420 Injection(s), anesthetic agent(s) and/or steroid CPT code 64421 is used when a healthcare provider performs injections of anesthetic agents and/or steroids into additional intercostal nerve levels following the primary procedure. ICD-10 codes show why a service was performed, that is, they establish medical necessity and also determine if the circumstances in which the service was provided are in accordance with the payer’s coverage . 2: Pelvic and perineal pain: Pudendal nerve block: CPT codes not covered for indications listed Aug 19, 2024 · 64420 . Feb 26, 2020 · The 2020 CPT update changed 64421 to an add-on code to 64420. Column 1 Column 2 Description 1 - Modifier (allowed) 0 - Modifier Jun 8, 2020 · There are several revised codes, three code deletions and six new codes in the nervous system. 10 and M79. What does 'level' mean in the code descriptor? This is how I am interpreting: If 1 injection is given at T3 and 4 nerves are treated , then code 64420. cihqdsfxqknmdrqufihbegecefkfmalwvtpmfspedavkxrglzfkbdfvllpwopadmsrxcytzka