12/06/2017

Correct Coding for a Neuroma Injection

What CPT code do you use for neuroma injection? I got denied for 64455 with remark codes: M25, N115. Thanks.

CPT 64455 is the correct procedure code for a neuroma injection. The charge was denied by Medicare because the diagnosis reported is not medically necessary for the procedure. Per the Medicare LCD for pain management injections (https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=36850&ver=14&CoverageSelection=Local&ArticleType=All&PolicyType=Final&s=New+York+-+Entire+State&CptHcpcsCode=64455&bc=gAAAACAAAAAAAA%3d%3d&), only three diagnosis codes are medically necessary:

G57.61*  Lesion of plantar nerve, right lower limb
G57.62* Lesion of plantar nerve, left lower limb
G57.63* Lesion of plantar nerve, bilateral lower limbs