For payers following CPT guidelines, this service, code 64450 (Injection, anesthetic agent; other peripheral nerve or branch) can no longer be separately coded when performed as a component of a surgical procedure. In this instance, a digital nerve block is clearly bundled as part of the global surgical package, as outlined in the CPT Introduction to the Surgical section-CPT Surgical Package Definition. Under Medicare's global services package rules, digital nerve blocks have always been bundled when performed as a component of a surgical procedure. Thus, when performing a nerve block for a laceration repair of a finger, only the laceration repair should be coded and not the nerve block.
However, digital nerve blocks performed as a stand-alone procedure and not part of a surgical package, (e.g., for pain control alone) generally remain separately codeable under both Medicare and CPT coding principles.
As a side note, code 64450 can also typically be coded when performing dental nerve blocks.