Query for Anatomical Specificity
Question: A provider documented that they performed a popliteal block. I cannot find a CPT® code that specifically mentions the popliteal nerve. How should I code this? Texas Subscriber Answer: While you should always code to the documentation available, understanding the anatomy of the sciatic nerve is helpful here. When a provider performs a popliteal block, they may be targeting the sciatic nerve at the popliteal fossa. Therefore, you should look for codes specifying use of an anesthetic agent on the sciatic nerve. You can help your providers understand that accurately reporting this service depends on documenting the specific nerve targeted. In this situation, some coders assign 64445 (Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve …), which has a work relative value unit (RVU) of 1.39, while others look to 64450 (Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch) for procedures documented as such. However, 64450 only has an RVU of 0.75, and reporting it due to an inexact description in the medical record may cause the service to be undervalued. You can find RVU values with AAPC’s RVU calculator. Of course, if popliteal is the only anatomical information given, you should query your provider as to which nerve was being targeted, and that should lead you to the right code. Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC
