CPT® Code 64454

The procedure described by CPT® Code 64454 involves the injection of anesthetic agents and/or steroids into the genicular nerve branches, which are located around the knee. This procedure is primarily utilized to diagnose the source of knee pain that may arise from various conditions such as arthritis, meniscal tears, trauma, or other inflammatory issues. By performing a genicular nerve block, healthcare providers can assess whether these pathological changes are contributing to the patient's pain. Additionally, this procedure helps determine if the pain will respond favorably to subsequent therapeutic interventions, which may include further injection blocks aimed at providing long-term pain relief, radiofrequency nerve ablation, or chemical neurolysis. Before the injection, the skin at the site is prepared, and a local anesthetic is applied to numb the area, ensuring patient comfort during the procedure. Depending on the patient's needs, intravenous (IV) sedation may be administered to enhance relaxation. The physician then advances a needle into the targeted area, typically utilizing fluoroscopic imaging guidance to confirm accurate placement near the genicular nerve. Once the needle is correctly positioned, the nerve-blocking agent is injected, often at multiple sites to effectively block all branches of the genicular nerve. Following the injection, patients can expect temporary pain relief, which may last for several hours before the pain returns. For diagnostic purposes, this procedure may be repeated within one to two weeks, as two successful tests are generally required to justify proceeding with longer-term treatment options. In cases where the injection is intended for therapeutic pain relief, the anesthetic agent is frequently combined with an anti-inflammatory corticosteroid, injected in a similar manner to enhance the overall effectiveness of the treatment.