Thank you. I thought that I was understanding that correctly but then when he stated he was doing 3 different branches of the same nerve I became confused because I found that the code is per nerve or branch. This is from one of his notes, so he would only get credit for one unit of 64450:
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PROCEDURE DESCRIPTION:
The patient was taken to the procedure room, where a time out was conducted using the following parameters: correct patient, correct procedure, correct side, and allergies. Thereafter, the patient was positioned in the supine position on the fluoroscopy table. Blood pressure and pulse oximetry monitors were placed allowing the patient to be monitored throughout the entirety of the procedure.
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The patient's knee was then placed on pillows as tolerated to offset a clear lateral view of each leg. The skin of the target knee was prepped and draped in the usual sterile fashion using ChloraPrep and sterile towels. Under fluoroscopy, the superior medial and lateral epicondyles of the femur, as well as, the distal aspect of the medial tibial epicondyle of the affected knee, were identified as the target zones for the injections, using an AP view. Each region was marked and the overly skin and subcutaneous tissues were infiltrated with a total of 3 mls of 1% Lidocaine. Using 3.5-inch, 22 gauge spinal needles, each target was approached and advanced using fluoroscopic guidance until reaching the midlevel of the femur and tibia. Needle tip positioning was confirmed using lateral fluoroscopic views and injecting 0.5 mls of contrast at each target site after aspiration was negative for air and heme.
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After a second negative aspiration, 1 mL of a solution containing 0.25% bupivacaine and 40 mg of Depo-Medrol was injected at each site. A sterile bandage was placed at each entry point. The patient tolerated the procedure well.