CPT® Code 64445

The procedure described by CPT® Code 64445 involves the injection of anesthetic agents and/or steroids into the sciatic nerve, which is a critical nerve that runs from the lower back down to the legs. This procedure is typically performed to alleviate pain associated with conditions affecting the sciatic nerve, such as sciatica, which can cause discomfort, numbness, or weakness in the lower extremities. The physician begins by flexing the patient's thigh at the hip to facilitate access to the nerve. A specific anatomical landmark is established by marking a line from the back of the knee to a point located between the greater trochanter and the ischial tuberosity, which helps guide the injection site. Prior to the injection, the skin is thoroughly cleansed and anesthetized to minimize discomfort during the procedure. To ensure accurate placement of the needle, the physician may utilize electrical nerve stimulation, which involves sending a small electrical current through the needle to elicit a motor response in the ankle, foot, or toes, or to confirm the presence of sensory responses such as numbness or tingling. Additionally, imaging guidance may be employed to enhance the precision of the injection. Once the needle is correctly positioned, the physician administers the anesthetic agent and/or steroid directly into the sciatic nerve, providing targeted relief from pain. This procedure is essential for patients suffering from nerve-related pain, as it can significantly improve their quality of life by reducing discomfort and enhancing mobility.