64405 2020 CPT Change

[amowens854]

I was going over some of the 2020 CPT changes and came across the code set 64400-64450 code descriptor changes. For example.....

64405--Injection, anesthetic agent; greater occipital nerve (NOW) 2020 CPT changed to 64405--Injection, anesthetic agent and/or steroid; greater occipital nerve (2020) If I am reading it correctly the steroid is now included and can NOT be billed separately if done, Correct? Any insight would be appreciated.

 

[jkyles]

Hi there, please see this CPT Assistant April 2005

Nervous System, 64400, 64450, 64505, 64530, 64999 (Q&A)

Question
Is it appropriate to report a nerve block injection code (ie, 64400-64450, 64505- 64530) if the injection is a combination of an anesthetic and steroidal agent (not solely an anesthetic agent as stated in the code descriptor)? Or should this combination injection be reported with the unlisted code, 64999, Unlisted procedure, nervous system?

AMA Comment

For a nerve block injection performed with an anesthetic and steroid combination, code 64999 should not be reported. Rather, a code from the 64400-64450 or 64505-64530 series should be reported, as appropriate. The inclusion of a steroidal agent does not alter the fundamental application of the nerve block injection codes (ie, 64400-64450, 64505-64530). The primary purpose of the injection would appropriately be captured with the nerve block injection codes (ie, 64400-64450, 64505-64530), and the addition of a steroidal agent would not change the code selection any more than the addition of diluents or other agents (eg, sarapin), provided the purpose of the injection is not to create tissue damage or nerve destruction.

Additional codes for the injection of the steroid should also not be reported, as this is captured in the primary code corresponding to the nerve block (ie, 64400-64450, 64505-64530).