Question Tenex Procedure for lateral epicondylitis

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linton@bresnan.net

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Discussion and research is ongoing regarding a tenex procedure on elbows within our coding/orthopedic group. What we have found is some say to use the unlisted code of 24999 and some say 24357. Below is a copy of the provider's op note and I am prone to use code 24357 as to me it explains the procedure better than using an unlisted code. Patient's insurance company is denying stating this procedure is experimental. Anyone have thoughts or wisdom to pass on, please?
Thank you,
Cindy

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It's not percutaneous needle tenotomy, it's ultrasonic ablation so it's not 24357.
Many or most payers are not going to cover it no matter which code you tried to use. It's experimental to most.
Examples: https://www.anthem.com/dam/medpolicies/abcbs/active/policies/mp_pw_c196772.html


I believe there are AHA coding clinics and/or CPT Assistant articles (I don't have access right now) but you would want to look those up for confirmation.
 
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