How do I report a procedure where the splanchnic nerve is injected with phenol?
Since the splanchnic nerve is part of the celiac plexus, and phenol is a neurolytic agent, you should report CPT code 64680, Destruction by neurolytic agent, celiac plexus, with or without radiologic monitoring.
From reading this CPT Assistant article it is evident that for a non-neurolytic Splanchnic nerve block that 64530. 77003/77002 is a column two code per CCI edits and it would not be appropriate to separartely report the fluoro. At the facility I work at, we would need a procedure note describing the procedure procedure with what was injected. Indications for the procedures and post procedure complication or lack of complications should be noted. Also that the physician went over other treatment options and the risks involve with the procedure. For 99144 documentation of the conscious sedation with start and end time, what medication was provided, who the trained observer was would have to be there. With what you have these would be enough to do the pre cert but not enough to accurately document what was performed.
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