Wiki Endoscopic rhizotomy

[moniquedawn]

I work in a medical office specializing in pain management. One of our surgeons asked me to find out if Tricare approves endoscopic rhizotomy. It is basically an RFA ( Radio frequency ablation, using and endoscope.) I have never billed for this type of procedure. When I tried to look it up in AMA's CPT book, the closest I got was 63185 Laminectomy and rhizotomy, but this isn't accurate. A DME representative told me to use 64772 - Transection or avulsion of other spinal nerve, extradural. But, this doesn't mention anything about endoscopic approach, or how the nerve is identified.

Has anyone billed this type of procedure? Is it considered unlisted 64999 - nervous system?

I am billing Tricare, and it would most likely be "questionable service" pending MCSC review.

Any insight is appreciated.

 

[dwaldman]

I don't believe the other codes you mention are correct (63185, 64772)

Below is from the AMA guidance, which states for destruction of facet joint nerves, if CT or fluoroscopic imaging is not used, report 64999
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Image guidance [fluoroscopy or CT] and any injection of contrast are inclusive components of 64633-64636. Image guidance and localization are required for the performance of paravertebral facet joint nerve destruction by neurolytic agent described by 64633-64636. If CT or fluoroscopic imaging is not used, report 64999)