Nerve Blocks for Peripheral Neuropathy

Nerve Blocks for Peripheral Neuropathy

by abilling, May 14, 2014

Nerve Blocks for Peripheral Neuropathy are not considered medically necessary

64450          INJECTION, ANESTHETIC AGENT; OTHER PERIPHERAL NERVE OR BRANCH

 

Coverage Indications, Limitations, and/or Medical Necessity

Nerve blocks cause the temporary interruption of conduction of impulses in peripheral nerves or nerve trunks by the injection of local anesthetic solutions.

The use of nerve blocks or injections for the treatment of multiple neuropathies or peripheral neuropathies caused by underlying systemic diseases is not considered medically necessary. Medical management using systemic medications is clinically indicated for the treatment of these conditions.

 

Limitations

The use of nerve blocks with or without the use of electrostimulation, and the use of electrostimulation alone for the treatment of multiple neuropathies or peripheral neuropathies caused by underlying systemic diseases is not considered medically reasonable and necessary.

At present, the literature and scientific evidence supporting the use of peripheral nerve blocks with or without the use of electrostimulation/electromagnetic stimulation, and the use of electrostimulation/ electromagnetic stimulation alone for neuropathies or peripheral neuropathies caused by underlying systemic diseases, is insufficient to warrant coverage. These procedures are considered investigational and are not eligible for coverage for the treatment of neuropathies or peripheral neuropathies caused by underlying systemic diseases.

The use of ultrasound guidance in conjunction with these non -covered injections is also considered not medically necessary and will result in denial.

Subcutaneous injections do not involve the structures described by CPT code 64450, direct injection into other peripheral nerves, but rather the injection of tissue surrounding a specific focus. These therapies are not to be coded using CPT code 64450. This code addresses the additional work of an injection of an anesthetic agent (nerve block), into relatively more difficult peripheral nerves, rather than that involved in an injection of relatively easily localized areas.

Treatment protocols utilizing multiple injections per day on multiple days per week for the treatment of multiple neuropathies or peripheral neuropathies caused by underlying systemic diseases are not considered medically necessary.

Peripheral nerve injections will not be allowed unless medical records are reviewed and the services are approved during the redetermination process.

 

Wisconsin Physicians Service Local Coverage Determination (LCD34673)

Effective June 15, 2014

Iowa, Kansas, Missouri, Nebraska

 

 

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Reasonable attempts have been made to be accurate.  However, medical billing, collections, coding and compliance are part science, part art, and even experts sometimes differ.  Neither Anesthesia Billing, Inc., the editors, publisher, contributors, or consultants warrant or guarantee the information contained will be applicable or appropriate in all situations.  For information specific to your practice, consult a qualified professional.

The information included in this publication is provided, among other things, to alert you to legal developments and should not be considered legal advice.  Specific questions about how this information affects your particular situation should be addressed to your attorney.

Editor:  Philip Blann (pblann@anesthesiabilling.com).

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