CPT® Code 64446

Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed

The procedure described by CPT® Code 64446 involves the administration of anesthetic agents and/or steroids to the sciatic nerve through a continuous infusion method using a catheter. This procedure is typically performed to alleviate pain associated with conditions affecting the lower extremities, particularly those involving the sciatic nerve. The process begins with the physician flexing the thigh at the hip to access the sciatic nerve effectively. A specific line is marked on the skin, extending from the back of the knee to a location between the greater trochanter and the ischial tuberosity, which serves as a guide for needle placement. Prior to the injection, the skin is cleansed and anesthetized to minimize discomfort during the procedure. The physician then introduces a needle just above the marked line to locate the sciatic nerve, verifying its position through electrical nerve stimulation, which elicits a motor response in the ankle, foot, or toes, or through the onset of sensory changes such as numbness or tingling. Imaging guidance may also be utilized to ensure accurate needle placement. Once the correct position is confirmed, the procedure transitions to the continuous infusion phase, where a catheter is placed to allow for ongoing delivery of the anesthetic agent and/or steroid. This method not only provides immediate pain relief but also allows for sustained management of pain through the continuous infusion of medication, enhancing the overall effectiveness of the treatment.