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Neurology & Pain Management Coding Alert

Reader Questions:

Leave Neurolysis Code to the Side

Question: Encounter notes indicate that the provider performed an anesthetic injection for a Morton鈥檚 neuroma patient. During the encounter, the provider also destroyed the nerves that were responsible for carrying the pain (neurolysis). I reported 64455 and 64632-59 and received a denial. What did I do wrong?

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Answer: You should have left 64632 (Destruction by neurolytic agent; plantar common digital nerve) off of the claim. Even though you appended modifier 59 (Distinct procedural service) to indicate a separate procedure, it doesn鈥檛 matter.

Why? The only code you should report for anesthetic injection and neurolysis for the same Morton鈥檚 neuroma patient is 64455 (Injection(s), anesthetic agent(s) and/ or steroid; plantar common digital nerve(s) (eg, Morton鈥檚 neuroma)). Per CPT2023, 鈥淒o not report 64455 in conjunction with 64632.鈥