Charging 64435, paracervical block with procedures

I think 64435, paracerivcal block, is included in procedures when done by the same surgeon in the office. CCI edits state that anesthesia cannot be charged by the physican who is performing the procedure. We have billed it with IUD insertions and it is always denied as included in the procedure. I do not think it is appropriate to add modifier 59, it is not a different incision, site, etc. What do you think?

64435

What procedure code are you billing this with? What payer?

64435

Any local anesthesia administered by the attending physician (i.e., pudendal block or paracervical block) is considered part of the procedurel coverage by most payors, there may be exceptions by payer policy.

any payer