Wiki Iovera

[lcole7465]

Some of my Ortho providers have begun using this product for knee injections for OA.

Has anyone billed this drug and injection (CPT 64640). If so, has this been paid by insurance or denied?

Thanks

 

[AlanPechacek]

After Googling Iovera, this is not an "injection" in the usual sense that some material/medication/solution is actually placed into the tissues or joint. It is a denervation of a peripheral nerve utilizing cold to "freeze" the nerve, thus killing it, at least for a while. The nerve may possibly recover/regenerate from this process over time, so it may be temporary. As I understand it, the needle(s) are put through the skin at the point where the nerve to be treated, then the needle(s) tip is turned freezing cold by using Liquid Nitrogen. As for the coding, you are using what appears to be the correct one. If there is an additional or potential charge for the instrument/device used, your physicians would have to contact the manufacturer or sales representative to see how it is done. It is FDA approved for knee arthritis.

Hope this helps some.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com

 

[bkilgroe]

We just started billing for this and were given the destruction codes by the manufacturer. We are getting paid but not sure that we should be. We found a T code that better describes this procedure, 0441T.

 

[Victoria323]

AMA contacted our site and informed us that we needed to use 64999, not 64640- Medicare will not pay now, Humana.. UHC.. w

 

[akaeb]

Are your providers doing this in the clinic or outpatient hospital?

 

[Victoria323]

in office

 

[elopezmanager]

I called the reimbursement support and spoke to Kelly. She insisted that the codes were correct, that this product is for cryoneurolysis not cryoablation and that is why 0440T is not the correct code. I am not comfortable using 64640 nor 64624. I use encoder pro and the description of these two CPT codes mention electrical current or the use of chemicals to destroy the nerve. Will anyone provide any information or knowledge about this product and its proper code---thank you to everyone in advance

 

[obrien136@abe.midco.net]

We have a doctor that does the iovera in four seperate nerves and we use the 64640x4 and get paid by medicare. Some commercial carriers don't cover saying it is experimental but let you know this when pre auth is obtained

 

[ms.bones206]

We have a doctor that does the iovera in four seperate nerves and we use the 64640x4 and get paid by medicare. Some commercial carriers don't cover saying it is experimental but let you know this when pre auth is obtained

Hello, I work for an Orthopedic practice and I am coding our 1st IOVERA Cryoneurolysis procedure. I know to use 64640, but in the CPT book it doesn't say 'each' so I don't know if I only code once for for all three nerves he did. Can you share with me some of your experience and knowledge of coding this please. These are the nerves and branches he addressed:
Measurements were made and treatment lines were drawn as followed. For the anterior femoral nerve and the superior branches of the inferior branch of the saphenous nerve and the inferior branch of the infrapatellar branch of the saphenous nerve.

Thank you,
Cyndi

 

[adunlap23]

We have been coding for the iovera procedures for a few months, and have had good luck with reimbursements. I find the attached guide helpful.