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piriformis muscle injection and periscatic nerve injection

Bill Posted Wed 02nd of April, 2014 13:11:23 PM

Can you please help me code the following: Procedure performed was 1)Rt piriformis muscle injection with fluoro 2)Perisciatic nerve injection with nerve stimulator under fluoro. Do I code "64445" and "20552"? Looks like 20552 is bundled in 64445 but can I bill with 59 modifier? Her dictation does indicate it was 2 separate procedures.

SuperCoder Answered Thu 03rd of April, 2014 15:45:56 PM

64445 (Injection, anesthetic agent; sciatic nerve, single) doesn't apply to piriformis muscle injections. The December 2011 issue of CPT Assistant clarified this question in an article about reporting piriformis and sciatic nerve injections.

The better choice for piriformis injection is 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscle[s]). If the provider uses fluoroscopic guidance, also report 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]).

The sciatic nerve injection code (64445)

I agree reporting with Modifier 59

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