Summary & Overview
CPT 64455: Digital Nerve Injection for Plantar Foot Pain
CPT code 64455 denotes a targeted injection of a steroid and/or anesthetic around the digital nerves on the plantar surface of the foot, a procedure commonly used for conditions such as Morton's neuroma. Nationally, this clinically focused intervention matters because it provides a minimally invasive option to relieve localized forefoot neuropathic pain and can reduce the need for systemic medications or more invasive surgery. Payers commonly covering this service in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context of the procedure, typical sites of service, and how this code is classified for billing purposes. The publication summarizes common payer coverage patterns and benchmarking metrics where available, highlights relevant policy considerations that affect access and reimbursement, and outlines related clinical scenarios that commonly drive use of the code. Data not available in the input is noted where applicable, and the piece focuses on national implications rather than state-level specifics.
Billing Code Overview
CPT code 64455 describes an injection of a steroid, an anesthetic agent, or both into the area surrounding the digital nerves on the sole of the foot. This procedure is commonly performed to treat localized neuropathic pain conditions such as Morton's neuroma.
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Service type: Targeted peripheral nerve injection
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Typical site of service: Outpatient clinic or ambulatory surgical setting on the foot
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Clinical & Coding Specifications
Clinical Context
A 52-year-old female presents to an outpatient podiatry clinic with a 6-month history of progressive forefoot pain and burning localized to the third interspace, worsened by walking and narrow shoes. Physical exam demonstrates a tender palpable mass between the third and fourth metatarsal heads and a positive Mulder click. Conservative care (shoe modification, orthotics, NSAIDs) produced incomplete relief. The provider performs an in-office digital nerve block with corticosteroid and local anesthetic injected into the plantar digital nerve sheath targeted at a suspected Morton's neuroma. The workflow includes informed consent, targeted exam and marking of the affected interspace, sterile preparation, local anesthesia and corticosteroid injection, brief observation for immediate adverse reaction, and documentation of laterality, medication names and amounts, needle size, and response to injection. Typical site of service is outpatient clinic or physician office; typical practitioners include podiatrists, orthopedic foot and ankle surgeons, and interventional pain specialists.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when an E/M visit above and beyond pre-procedure documentation is provided on the same day as the injection. |