Summary & Overview
CPT 64435: Paracervical or Uterine Nerve Injection
CPT code 64435 designates paracervical or uterine nerve injections of an anesthetic agent, steroid, or both alongside the cervix in female patients. This procedure code captures targeted regional injections used for diagnostic or therapeutic management of pelvic and cervical pain and is relevant to gynecology, pain management, and ambulatory procedural billing nationally. Accurate coding affects claims adjudication, clinical documentation, and utilization monitoring across payers.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines coverage and billing considerations observed across these major payers, common modifier usage, and clinical context for when CPT code 64435 is reported.
Readers will learn a concise clinical description of the procedure, typical sites of service, and the kinds of billing elements associated with paracervical or uterine nerve injections. The report also summarizes benchmarking expectations, common billing modifiers supplied in the input, and where data was not available. This national-level overview supports coding accuracy, payer conversations, and administrative planning for practices that perform gynecologic regional nerve injections.
Billing Code Overview
CPT code 64435 describes injection of an anesthetic agent, steroid, or both into the paracervical or uterine nerve in the area alongside the cervix in female patients. The code is reported for one or more injections of the paracervical or uterine nerve.
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Service type: Paracervical or uterine nerve injection (anesthetic and/or steroid)
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Typical site of service: Ambulatory surgical centers, hospital outpatient departments, or physician office settings where gynecologic procedures and regional nerve injections are performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 32-year-old female with recurrent severe dysmenorrhea and suspected uterine nerve-mediated pelvic pain presents to an outpatient gynecology interventional clinic for targeted pain control. Prior conservative measures including NSAIDs and hormonal therapy provided inadequate relief. The clinician performs a paracervical/uterine nerve block using a combination of local anesthetic with or without corticosteroid under sterile conditions. The procedure is performed in an ambulatory procedure room or outpatient clinic with the patient monitored in a supine position. After informed consent, the cervix is visualized; the provider injects the anesthetic adjacent to the cervix at one or more paracervical sites. The patient is observed for recovery, given post-procedure instructions, and discharged same day if stable. Documentation includes indication, informed consent, number of injections, agent(s) and dose(s), laterality if applicable, immediate response, and any complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician’s professional service separate from technical facility services |
50 | Bilateral procedure |