Question Knee Articular Sensory Diagnostic Nerve Block

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Newland, NC
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I need help with coding this procedure and the number of units to be billed. The provider has submitted CPT 64405 with 3 units and I am not sure about the # of units or how to list them for billing.
Procedure: RIGHT Knee Articular Sensory Diagnostic Nerve Block:
Nerve 1: superior tibial articular sensory nerve
Nerve 2: superior peroneal articular sensory nerve
Nerve 3: inferior tibial articular sensory nerve
(this diagnostic block was performed on 3 distinct separately identifiable anatomic structures.)
Description of Procedure: The patient was placed in the supine position and the area to be injected was prepped with chloraprep and draped in the usual sterile fashion. Fluoroscopy was used to localize the appropriate needle entry point. Local anesthesia was administered using a 27 gauge needle and 1% lidocaine.

Attention was directed to the RIGHT superior tibial articular sensory nerve. Using intermittent fluoroscopic guidance, a 21 gauge 3 1/2" spinal needle was advanced to the angle where the medial femoral condyle meets the femoral shaft. The needle was advanced to the midshaft of the femur.

Attention was directed to the RIGHT superior articular sensory nerve. Using intermittent fluoroscopic guidance, a 21 gauge 3 1/2" spinal needle was advanced to the angle where the medial femoral condyle meets the femoral shaft. The needle was advanced to the midshaft of the femur.

Attention was directed to the RIGHT inferior tibial sensory nerve. Using intermittent fluoroscopic guidance, a 21 gauge 3 1/2" spinal needle was advanced to the angle where the medial femoral condyle meets the femoral shaft. The needle was advanced to the midshaft of the femur.

Proper needle position was confirmed under multiplanar fluoroscopice visualization, after aspiration returned no blood, a 1.5 ml volume of 0.5% Bupivicaine without epinephrine was injected to achieve diagnostic blockade of the above articular nerves.

The needles were withdrawn to the skin surface, pressure was applied, and the insertion sites were dressed with sterile dressing.
 
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