​64600 
Destruction by neurolytic agent, trigeminal nerve; supraorbital, intraorbital, mental, or interior alveolar branch

64605
Desctruction by neurolytic agent, trigeminal nerve; second and third division branches at
foramen ovale

64610
Desctruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring

64620 
Destruction by neurolytic agent, intercostal nerve 

64624 
Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed

64630 
Destruction by neurolytic agent, pudendal nerve 

64640 
Destruction by neurolytic agent, other peripheral nerve or branch 

64680 
Destruction by neurolytic agent, with or without radiologic monitoring; celliac plexus

64681
Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus

​64400 
Injection, anesthetic agent; trigeminal nerve, any division or branch

64418 
Injection, anesthetic agent; suprascapular nerve

64420 
Injection, anesthetic agent; intercostal nerve, single

64421 
Injection, anesthetic agent; intercostal nerves, multiple, regional block

64425 
Injection, anesthetic agent, ilioinguinal, iliohypogastric nerves

64430 Injection, anesthetic agent, pudendal nerve

64447 Injection, anesthetic agent; femoral nerve, single

64450 
Injection, anesthetic agent; other peripheral nerve or branch

64454  
Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed

64505 
Injection, anesthetic agent; sphenopalatine ganglion

64510 
Injection, anesthetic agent; stellate ganglion (cervical sympathetic)

64517 
Injection, anesthetic agent; superior hypogastric plexus

64520 
Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)

64530 
Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring

Key points to remember:

• These code(s) can be unilateral (so make sure you append the right anatomical side MODIFIER);
• Some code(s) may be inclusive with the imaging guidance (you cannot bill it separate);
• Always check with the payers if your procedure(s) will need Prior Authorization or Precertification
• Always verify if it is a covered benefits for your patients.
• You can report for Moderate Conscious Sedation code 99152-99153 if performed by the same physician and patient is older than 5 years old.

Effective January 1, 2020, we have now a specific code for the Genicular Nerve Knee Block and the Genicular Nerve Knee Ablation. You can read more about that change in our blog. CLICK HERE.

I have been getting inquiries about their claims getting denied by the insurance payers including some contractors of Medicare. What I found is that, this is considered as Investigational and Experimental.

I commonly see the following guideline:
Genicular nerve blocks and genicular nerve ablation are considered investigational and not medically necessary for the treatment of chronic knee pain, including but not limited to any of the following:

• Degenerative joint disease;
• Osteoarthritis of the knee;
• As a treatment prior to knee replacement;
• As a treatment following knee replacement;
• As a treatment for individuals who are not candidates for knee replacement surgery.

I have seen two CMS Contractor who covers for this procedure based on Medical Necessity. See Group 1 Diagnosis Codes Cross Over:

Group 1 DX Codes:
M25.561 Pain in right knee
M25.562 Pain in left knee

Need help how to Appeal your claims? Contact Us today!

Need help how to obtain Pre-determination before you render the Genicular Nerve Block to your patients? You should contact us today!