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Wiki Lumbar Sympathetic Chain Radiofrequency ablation

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saracpm

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My provider performed this procedure under anesthesia at an out-patient facility. I am only billing for the procedure. The best code that I could find was 64640 but it is not being recognized by Medicare. I just submitted the procedure notes in hopes of receiving payment. Has anyone else had experience billing this procedure? Have you received payment from insurance companies for this procedure?
 
The lumbar sympathetic chain is not a somatic nerve (sensory) nerve. It would not apply to the 64640 code which is in the Destruction by Neurolytic Agent, Somatic Nerve CPT code section. There isn't a code for "destruction by neurolytic agent, other sympathetic nerve". RF ablation of the lumbar sympathetic plexus is typically reported with the 64999 unlisted code.
 
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