Wiki Scar Neuroma Coding Help

[amowens854]

I need some help in trying to figure out what the correct code would be for this visit. Below is what the doctor documented and he wanted to use code 64999.


Neuroma Injection:
Neuroma Injection: Left stump x 1 neuroma
Medications used for each neuroma: 3 cc of a solution containing Bupivacaine 0.5% and a total of Dexamethasone 10 mg .

After procedure explained to him and informed consent taken, the patient's skin was desinfected with Hibiclens . Each neuroma was then identified with palpation and marked . Using sterile technique, each neuroma was then injected with the medications listed above. All needles removed intact. The skin was then cleaned and sterile bandaids applied to treated areas.
The patient tolerated the procedure well, no complications. He was observed for 10 min. afterwards and discharched home in a satisfactory condition.


I was looking at codes 64450 and 64455 but I'm not sure which one.
Any help would be great.

 

[jkyles]

Hi there, 64455 describes an injection for a plantar interdigital neuroma of the foot (Morton's neuroma). Based on the note the patient did not have an injection of the foot. In response to a question about neuromas, CPT Assistant Nov 2013 states in part:

A “neuroma” is a thickening of scar tissue on the nerve and/or lining of the nerve; therefore, the appropriate nerve injection code should be reported based on the nerve injected.