Eli's Rehab Report

Question: Our physiatrist documented a left peroneal sural nerve block. He indicates that he used lidocaine for temporary relief of the patient's pain. Which CPT code should I use for this?

Massachusetts Subscriber

Answer: You can code the injection with 64450* (Injection, anesthetic agent; other peripheral nerve or branch), but you cannot bill separately for the lidocaine (J2000). Medicare will not accept claims for this drug when billed with any ICD-9 code other than those related to cardiac arrhythmias and emergencies. For example, Georgia Medicare's policy for lidocaine states, "The dosage indicated by the code description is specific to the treatment of cardiac arrhythmias and emergencies only. The billing of J2000 is not appropriate for the 1-2 cc usually required for a local anesthetic."