Wiki Inquiry Regarding CPT Code 64640 & HCPCS Code C9809

[dsibley67]

I'm looking for information regarding CPT code 64640 & HCPCS code C9809. Has anyone billed for these procedures and successfully received payment? If so, I'd appreciate any details or insights you can share.
Thank you in advance for your help!

 

[NRaizman]

What is the actual question?

64640 is a standard code and has been there for decades. We've largely gone from using phenol and other destructive agents to the new trend of thermal ablation. Pacira's Iovera system gets a separate pass through reimbursement from the NOPAIN Act. It amounts to a little over $250. Not sure that covers the cost. And it is only for ASC/HOPD, not in-office.

No private payor is required to reimburse that and they may have completely separate policy or LCD.

 

[jkyles]

There's confusion around 64640 for iovera because in 2019 the CPT Assistant stated it can be used to report cryoneurolysis. Some people thought that meant they could bill iovera treatments with the code. However, the AMA doesn't set payment policy. As stated above you'll need to check each payer to see if they cover iovera at all, the required conditions and which code(s) you can use.