AAPC - Back to school
Results 1 to 5 of 5

Thread: Right Lower Extremity Stump Neuroma

  1. #1

    Default Right Lower Extremity Stump Neuroma

    AAPC: Back to School
    Once again, please help. Procedure: Right lower extremity neuroma injection with insulated needle and nerve stimulation/
    With the patient having had an IV started ans all routine monitoring intact to include noninvasive blood pressure cuff and continuous pulse oximetry; the patient was placed in a prone position. The painful region was identified in the right popliteal fossa with visual palpation. We then anesthetized the superficial skin with 1% lidocaine local anesthesia. Through the anestheized skin we placed a radiofrequency needle with a 10 mm active tip. It was advanced with use of sensory simulation. Sensory stimulation reproduced the patient's pain originally at a tubal setting. The average was decreased with stimulation obtained at 0.2 V. After obtaining the stimulation we then prepared a solution containing 1-1/2 cc of Celestone Soluspan 10 mg and 6 cc of 0.25% bupivacaine. After negative aspiration the solution was injected incrementally. The needle was then removed and the are was sterilely cleaned and bandaged. the patient had a preoperative pain level of 7/10 and a postoperative pain level of zero. the patient was discharged with no apparent complications and will followup accordingly.
    Please advise what CPT code you would use. Thanks for your help

  2. #2


    Please cam anyone help me with this? Thanks

  3. #3
    Join Date
    Apr 2007


    It sounded like an effective procedure but it seemed like 64450 (popiteal region) was less work RVU then what was carried out. The stimulation would be inclusive to the procedure. I noticed it said the injection was done incrementally but did not notice a catheter being used. I believe it would be 64450 but held off on responding because I was not sure if I was missing something.

  4. #4
    Join Date
    Apr 2007


    I was responding with 64450 in mind for the neuroma the same as neuroma injection can be reported with a nerve block code:
    Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton's neuroma)

    Three is also the CPT Assistant reference for painful scar tissue as 64999.

  5. #5


    Thank You as always dwaldman, but you were right there was no mention of a catheter being used. I am like you I was leaning towards 64450 but was not for sure if I was missing something too. As awlays you have provided great information.

Similar Threads

  1. Replies: 5
    Last Post: 02-26-2015, 04:29 PM
  2. Stump Neuroma RFA
    By kellit21 in forum Anesthesia
    Replies: 1
    Last Post: 07-21-2014, 10:27 PM
  3. CT lower extremity
    By bryson1019 in forum Interventional Radiology
    Replies: 0
    Last Post: 05-03-2013, 03:03 PM
  4. Replies: 3
    Last Post: 07-27-2011, 12:10 AM
  5. ct lower extremity
    By gladys font in forum Interventional Radiology
    Replies: 1
    Last Post: 10-15-2010, 09:51 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.