Neurology & Pain Management Coding Alert

Question: I thought we could use 64445 for a piriformis muscle injection, but one of my co-workers disagrees. Who's right? New Jersey Subscriber Answer: Your co-worker is correct in saying 64445 (Injection, anesthetic agent; sciatic nerve, single) doesn't apply to piriformis muscle injections. The December 2011 issue of CPT Assistant clarified this question in an article about reporting piriformis and sciatic nerve injections. The better choice for piriformis injection is 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscle[s]). If the provider uses fluoroscopic guidance, also report 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]).