lindmarie76
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We have been researching to find the appropriate code for RF destruction of paravertebral lumbar sympathetic chain. One of our doctors dictates it as follows:
1. Procedure Line states- RF of left L2, L3 and L4 lumbar sympathetic chain.
The body states: A series of 3 individual curved RF needles were then placed into the anterolateral aspects of each vertebra being L2,L3 and L4. The position was confirmed to be along the sympathetic chain with 1-2 cc of Omnipaque 300 at each one of the three needles. The patient then underwent motor and sensory testing. Each of the 3 medial nerve branch nerves were then anesthetized with bupivacaine. The patient then rec'd RF ablation at each level with two lesions being 60 seconds in duration at 80-C with normal impedence.
I have coded this as a regular lumbar RF lesioning 64622-23 in December of 2011. I now would code this as 64635-36 in 2012. But we are being told to use 64640 by one of the physicians and we need affirmation from a reliable source for a coding round table with the doctors.
Thank-you,
Linda Vassallo, CPC
lvassallo@pmbanj.com
1. Procedure Line states- RF of left L2, L3 and L4 lumbar sympathetic chain.
The body states: A series of 3 individual curved RF needles were then placed into the anterolateral aspects of each vertebra being L2,L3 and L4. The position was confirmed to be along the sympathetic chain with 1-2 cc of Omnipaque 300 at each one of the three needles. The patient then underwent motor and sensory testing. Each of the 3 medial nerve branch nerves were then anesthetized with bupivacaine. The patient then rec'd RF ablation at each level with two lesions being 60 seconds in duration at 80-C with normal impedence.
I have coded this as a regular lumbar RF lesioning 64622-23 in December of 2011. I now would code this as 64635-36 in 2012. But we are being told to use 64640 by one of the physicians and we need affirmation from a reliable source for a coding round table with the doctors.
Thank-you,
Linda Vassallo, CPC
lvassallo@pmbanj.com