Facet Nerve RF Ablation/Rhizotomy: 64622, 64623, 64626, 64627 has been DELETED!
64622 Destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, single level
64623 Destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, each additional level (List separately in addition to code for primary procedure)
64626 Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level 64627 Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, each additional level (List separately in addition to code for primary procedure)
Your New Codes effective January 01, 2012 are:
64633 Destruction by neurolytic agent, paravertebral facet joint nerve (s) with imaging guidance (fluoroscopy or CT); cervical or thoracic; single facet joint +64634 cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)
64635 Destruction by neurolytic agent, paravertebral facet joint nerve (s) with imaging guidance (fluoroscopy or CT); lumbar or sacral; single facet joint +64636 lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)
Pointers on HOW to PROPERLY USE THESE CODES:
1. These codes are no longer billable at a service unit(s) on a per single nerve at a single vertebral level; 2. You have to remember that there are 2 spinal nerves that inervates each single facet joint; 3. Anatomically, there are 2 facet joints (left and right) on each vertebral level; 4. These codes are billable per facet joint; which means, if 2 facet joints were treated on the same vertebral level, then you will report the primary code with a modifier -50 to indicate a bilateral procedure;
Here are your number of pairs for your Spinal Nerves: There's a total of 31 pairs. Cervical 8 pair Thoracic 12 pair Lumbar 5 pair Sacral 5 pair Coccyx 1 pair
Also note that imaging guidance is inclusive and that per CPT guideline, fluoro or CT (imaging guidance) is required for the performance of these procedures.
Otherwise, we are being further instructed that if imaging guidance (Fluoro or CT) is not used, it is appropriate to use the unlisted procedure code 64499 (Nervous System).