Below is from CPT Assistant Sept 2010
Question:The patient has postmastectomy pain in the scar tissue area and not in the muscle. An injection was performed into the scar tissue of the chest area using a mixture of triamcinolone topical, lidocaine with epinephrine, and bupivacaine hydrochloride with epinephrine. What CPT code should be reported for this procedure?
Answer:Injection of painful scar tissue is reported using CPT code 64999,Unlisted procedure, nervous system. When reporting an unlisted code to describe a procedure or service, it is necessary to submit supporting documentation (eg, procedure report) along with the claim to provide an adequate description of the nature, extent, and need for the procedure, and the time, effort, and equipment necessary to provide the service.
In the past I was under impression to use 11900
Injection, intralesional; up to and including 7 lesions
The physician uses a syringe to inject a pharmacologic agent underneath or into seven or fewer skin lesions in 11900 and more than seven lesions in 11901. The lesions may be any healed skin lesions including post-laceration and post-surgical scar bands. The physician may inject steroids or anesthetics (not pre-operative local anesthetic) into these lesions.
Then I saw the above CPT Assistant and was confused what code to use for a scar/incision neuroma injection. Would it fall under painful scar tissue and use 64999? I don't think it would be inappropriate to use an unlisted code for the procedure you are describing.
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