CPT® Code 64430

The CPT® Code 64430 refers to the procedure of injecting anesthetic agents and/or steroids into the pudendal nerve, commonly known as a pudendal nerve block. This procedure is primarily performed to alleviate pain during the second stage of labor, providing significant relief for women experiencing childbirth. The pudendal nerve block is particularly beneficial in situations where pelvic floor relaxation is necessary, such as during forceps delivery, and it also serves to anesthetize the perineum for the creation or repair of an episiotomy. The procedure can be executed through two distinct approaches: transvaginal and transcutaneous perineal. In the transvaginal approach, the physician palpates the ischial spine to locate the nerve, utilizing a Huber needle to control the depth of penetration. Conversely, the transcutaneous perineal approach involves palpating the ischial tuberosity and introducing the needle slightly medial to it. Both methods require careful aspiration to confirm the correct placement of the needle and to avoid inadvertent injection into blood vessels, ensuring the safety and efficacy of the anesthetic delivery.