Neurology & Pain Management Coding Alert
Don't Report 64633-64636 for Ultrasound Guidance
Question: Our physician used ultrasound guidance during destruction of paravertebral facet joint nerves. How do we bill the procedure?
Answer: You’ll need to report 64999 (Unlisted procedure, nervous system).
Here’s why: The codes that represent paravertebral facet joint nerve destruction are 64633-64636 (Destruction by neurolytic agent, paravertebral facet joint nerve[s], with imaging guidance [fluoroscopy or CT] …). The descriptor specifies fluoroscopic or CT guidance, so you shouldn’t use these codes when the provider uses ultrasound guidance. Category III codes also do not include a choice for paravertebral facet joint nerve destruction under ultrasound.
Alternative: You can, however, choose the appropriate code from 64633-64636 that best represents the nerve destruction as your comparison code and procedure compensation when submitting your claim with 64999.
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Neurology & Pain Management Coding Alert
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