Wiki 76942 WITH 64450 AND 64445

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TonyaCarlson

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I've just been told that I'm not able to use 76942 with 64450 when I'm also coding 64445 at the same time ie 64445-59, 64450-59, 76942-26-59 because of the block guidelines. I believe they are interpreting the guidelines wrong when they are reading code imaging guidance when used except with 64415-17, etc. Is anyone able to clarify that I'm right and point me to the information to back that up if I am correct?
 
If the descriptor for the peripheral block isn't enough I think the list of codes under the ultrasound code in the CPT Manual is your best bet. The peripheral block isn't included.

You're probably going to have to prove on appeal that the peripheral block was distinct from the sciatic block and that the image guidance was performed for the peripheral block but that doesn't mean you can't report it.
 
Please refer to page 495 of the 2025 CPT manual for the chart indicating CPT codes that have U/S bundled into the codes & which do not.

The correct coding for your scenario would be:
64445-59, RT or LT
64450-59, RT or LT
76942-26

Modifier 59 is not appended to 76942.
 
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