Wiki Genicular Nerve Block - CPT 64450

[lcole7465]

This injection is a little confusing for me, I know it's per nerve or branch. But I keep getting a little stuck on this one. My doctors note reads: I identified the right lateral superior genicular nerve branch at the junction of the lateral femoral shaft and lateral condyle; the right medial superior genicular nerve branch, at the junction of the medial femoral shaft and medial condyle; and the right medial inferior genicular branch, at the junction of the medial tibial shaft and condyle. Local anesthetic administration was performed using 2mL of lidocaine 1% at each location. Then using a 22-gauge spinal needle was directed to each end point identified above, confirming proper positioning under fluoroscopy in AP view. After negative aspiration, we injected consisting of 1.5mL of 0.25% bupivicaine and 10mg of Depo-Medrol and each branch of the genicular nerve.

I know 64450 is usually 1 UOS since it's per nerve or branch My doctor wants to bill 3 UOS.

Any input would be helpful.

 

[Melissa Harris CPC]

Unfortunately you can only bill for 1 unit even when they inject the 3 branches. It is listed in the MUE - maybe you can show your provider. However, the RFA of the Genicular nerve has no guidelines and I would bill it as 3 units.

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management