Pain Management Coding Alert

Question: An established patient reports to the PM specialist for scheduled spinal radiofrequency (RF) ablation. How should I code this encounter?

Massachusetts Subscriber

Answer: You'll need some more information, from either the encounter notes or the providing PM specialist, before making your decision.

You have four codes to choose from when coding spinal RF ablation, based on the spinal area and number of joints treated in that spinal area:

• 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).

Best bet: Check the encounter notes and ask the providing specialist for the exact locations of each spinal RF ablation you code.

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