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Neurosurgery Coding Alert

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Facet Injections Describe Neurolysis

Published on Fri Nov 19, 2004

Question: How should I code bilateral occipital neurolysis with cryoablation? Also, how should I code cervical median descending branch nerve neurolysis via cryoablation (for C5, C6, C7)?

Minnesota Subscriber Answer: Code the occipital neurolysis with 64640 (Destruction by neurolytic agent; other peripheral nerve or branch). Be sure to append modifier -50 (Bilateral procedure) to show that the neurosurgeon provided the service bilaterally.

Code each injection of the cervical median nerve neurolysis via cryoablation separately. Report 64626 (Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level) and +64627 (... cervical or thoracic, each additional level [list separately in addition to code for primary procedure]) twice (for the second and third injections), or report them on separate lines with C5, C6 and C7 designations beside the codes.
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