A 44-year old female patient presents to the emergency room suffering from dental pain due to a cracked tooth. The patient states she has had gradual worsening of her pain for the last several days. A dental block (injection of regional anesthesia) was performed for the pain with Marcaine and Epinephrine. Complete pain relief was experienced by the patient following the injection. Would this injection be assigned with CPT code 64450, Injection, anesthetic agent; other peripheral nerve or branch, and an evaluation and management (E/M) code? Or, would it be appropriate to assign the E/M code and to not separately report the injection?
Report CPT code 64400, Injection, anesthetic agent; trigeminal nerve, any division or branch, for the injection of the regional anesthesia. The trigeminal nerve, also known as the fifth nerve, is the largest of the cranial nerves and conveys sensory function via three branches of the trigeminal nerve, i.e., the ophthalmic nerve, the maxillary nerve, and the mandibular nerve. The maxillary and mandibular nerve both carry sensation from the lip, teeth and gums.