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nerve blocks

Mike Posted Tue 19th of January, 2016 16:41:50 PM

We gave a cutaneous nerve block for neuralgia of the right lateral femoral cutaneous nerve. Is the diagnosis proper coding G57.21 or M79.2. I don't understand why Neuralgia/ neuritis is in the Musculoskeletal system in the ICD10 if this is dealing with nerves.
I also see the exclusions under M79.2, we are having problems with some carriers covering 64450 with the G codes G56-G58 in the ICD10 on mononeuropathies yet the carriers will pay for a block with M79.2.

Can you enlighten me on the diagnosis coding?

SuperCoder Answered Wed 20th of January, 2016 08:42:50 AM

ICD M79.2 is the most appropriate diagnosis code for right lateral femoral cutaneous nerve.
As per code classification M79 comes under other and unspecified soft tissue disorders, not elsewhere classified.

Since muscles and nerves are closely related to each other, as different nerves supply the muscles, so neuralgia/ neuritis is kept in the Musculoskeletal system in the ICD-10

Mike Posted Wed 20th of January, 2016 12:54:12 PM

Well, This patient also has a diagnosis of Meralgia paresthetica G57.11 and nerve compression. This is why G57.21 was used and not M79.2.

Am I still using the incorrect code?

SuperCoder Answered Thu 21st of January, 2016 05:08:04 AM

It is correct to use ICD G57.11 for Meralgia paresthetica and M79.2 for neuralgia of the right lateral femoral cutaneous nerve. As per these codes are billable with CPT code 64450.

As per, CPT code 64450 may not be billed with diagnosis G57.61 and G57.62.

Please find the link below to find out the ICD codes allowed with 64450.|Ed&PolicyType=Final&s=All&CptHcpcsCode=64450&kq=true&bc=IAAAABAAAAAAAA%3d%3d&

To add more, as per documentation CPT code for nerve block for neuralgia of the right lateral femoral cutaneous nerve is 64447.

Mike Posted Thu 21st of January, 2016 19:32:24 PM

Where do you get this information on 64447 code for a lateral femoral cutaneous never block, because I have a supercoder answer from a couple years ago that said "an injection of the lateral femoral cutaneous nerve would be reported with the 64450 CPT code because this is a totally different nerve from the femoral nerve." (by user 14912 for a question of infiltration of groin)

Is there a CPT assist to use 64447 on the lateral femoral cutaneous nerve? I would love to use that code for this type of injection.

SuperCoder Answered Fri 22nd of January, 2016 09:00:34 AM

Since Lateral femoral cutaneous nerve originate directly from lumbar plexus(L2 and L3)and is not the branch of femoral nerve, So CPT code 64450 is the correct code to bill for lateral femoral cutaneous nerve.

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