Intercostal RFA CPT

[ksellman]

We do a thermal, non pulsed radiofrequency ablation. We did an intercostal RFA today so we would bill 64640. But how can we bill for the fluoroscopic guidance if 77003 isn't allowed to be an add on code for 64640?

 

[thomas7331]

This isn't my specialty, but I think you're using the wrong code - the destruction of the intercostal nerve should be 64620 and the fluoroscopic guidance is inclusive to that code and not separately billed, per CPT instructions. Perhaps someone else here with more experience in these procedures can confirm this.

 

[jkyles]

This isn't my specialty, but I think you're using the wrong code - the destruction of the intercostal nerve should be 64620 and the fluoroscopic guidance is inclusive to that code and not separately billed, per CPT instructions. Perhaps someone else here with more experience in these procedures can confirm this.

This is correct. The only addition I would make for people who aren't familiar with this is these are two examples of stealth inclusion of fluoroscopy. It isn't included in the descriptor for the peripheral or intercostal procedure, but they aren't listed as primary codes for 77003.

 

[JamieAnderson]

I'm looking at CPT code 64620 (Destruction by neurolytic agent, intercostal nerve) and 77002 would be bundled into 64620 and not separately coded. I say 77002 and not 77003 because 77003 is specific to spinal or paraspinal.

 

[Melissa Harris CPC]

An intercostal nerve radiofrequency is billed as 64620 per level and you cannot bill fluoroscopy separately.

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management