What is a medial branch neurotomy?

A medial branch neurotomy is a non-surgical procedure which cauterizes the nerves (through very localized heating) that allow you to feel pain caused by your facet joints. Your facet has been proven to be painful by diagnostic injection procedures, but your pain has not been reduced by other treatment methods.

What is the CPT code 64490?

The CPT codes 64490 and 64493 are intended to be used to report all of the nerves that innervate the first level paravertebral facet joint and not each nerve.

What is the CPT code for radiofrequency ablation of medial branch nerves?

Neurolytic Destruction Procedures (Radiofrequency Ablation): For destruction of paravertebral facet joint medial branch nerves, image guidance and localization (fluoroscopy or CT) are required and inclusive in codes 64633, 64634, 64635, and 64636.

What are the CPT codes for medial branch block?

According to the AMA, the code series for medial branch blocks and the facet joint injections are the same (i.e., CPT series 64490-64495), with reporting based on the number of facet joints injected, not the number of nerves injected.

What CPT code is 64635?

The Current Procedural Terminology (CPT®) code 64635 as maintained by American Medical Association, is a medical procedural code under the range – Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) Procedures on the Somatic Nerves.

How do I bill 64635 and 64636 bilateral?

Whether a paravertebral facet joint/nerve denervation is performed unilaterally or bilaterally, use CPT code 64635 or 64636 for the first level denervated. If a second level is denervated unilaterally or bilaterally, use CPT code 64636 or 64634.

Is radiofrequency neurotomy the same as radiofrequency ablation?

Radiofrequency neurotomy (RFN), also known as radiofrequency ablation (RFA), is a common interventional procedure used to treat pain from an innervated structure. RFN has historically been used to treat chronic facet-joint mediated pain.

What is the difference between MBB and RFA?

A medial branch block uses medication to numb the joint capsule. RFA, on the other hand, destroys the nerve endings completely. Destroying the nerve endings extends the effectiveness of the procedure for 1 year or more. MBB can last 2-3 months, which means a patient can get multiple treatments yearly.

What is the CPT code for a medial branch block?

What is procedure code 64520?

64520. INJECTION, ANESTHETIC AGENT; LUMBAR OR THORACIC (PARAVERTEBRAL SYMPATHETIC)

What is procedure code 64632?

CPT® Code 64632 – Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) Procedures on the Somatic Nerves – Codify by AAPC.

Is CPT 64635 bilateral?

The CPT codes 64635-64636 have a bilateral surgery indicator of “1.” Thus, they are considered “unilateral” procedures and the 150% payment adjustment for bilateral procedures applies.

What is medial branch radiofrequency ablation?

In Medial Branch Radiofrequency Ablation, your expert pain physician uses radio waves to destroy the nerve fibers that carry those pain signals along your medial branch nerves to block the pain and help you achieve relief.

Is a medial branch block the same as RFA?

Can 64490 and 64493 be billed together?

64491 should be reported in conjunction with 64490 and 64494 should be reported in conjunction with 64493.

What is the proper billing for medial branch blocks?

Note: For medial branch blocks, the proper billing is to bill for each complete facet joint blocks (see example below) Ex: Bilateral L3, L4, L5 MBBs would be billed as 64493 -50, 64494 -50. Note: The third occipital nerve (TON) partially innervates the C2/3 facet joint, so along with a C3 MBB, this would be billed as one full joint (64490)

What is the CPT code for sacral lateral branch block?

Sacral lateral branch blocks: 64450 (remember to bill 77003 with these, but not with the 64493 code) Radiofrequency Ablation (RFA) of the Sacroiliac Joint RF of L5 dorsal primary ramus: 64635 RF of S1 lateral branches: 64640

What is the CPT code for nerve damage to the cervical spine?

Some of the codes mentioned in the article below have changed – 76005 is now 77003 – 64470 thru 64476 are now 64490 thru 64495 The destruction by neurolytic agent (eg, chemical, thermal, electrical, radiofrequency) codes (64622-64627) refers to paravertebral facet joint nerve destruction at the cervical, thoracic, lumbar, or sacral region (s).

What is the CPT code for third occipital nerve block?

We use the code 64450 (other peripheral nerve) for third occipital nerve (TON) blocks. More importantly than the actual joint, for medial branch blocks, you need to look at the actual medial branch nerves (facet nerves) that were blocks.