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CPT codes 64475 and 64476

  1. #11
    Location
    Woodland Hills, CA
    Posts
    121
    Default
    Medical Coding Books
    Karen, might you also know how to code the following?
    Radiofrequency rhizotomy of the right lumbar medial branch nerves at L2, L3, L4, L5, S1, needle localization?

    Thanks in advance,
    Lilit
    CPC CCS
    "The true way to render ourselves happy is to love our work and find in it our pleasure."

  2. #12
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    Quote Originally Posted by lmartirosyan View Post
    Karen, might you also know how to code the following?
    Radiofrequency rhizotomy of the right lumbar medial branch nerves at L2, L3, L4, L5, S1, needle localization?

    Thanks in advance,
    Lilit

    64622-rt L2-3
    64623-rt L3-4
    64623-59-rt L4-5
    64623-59-rt L5-S1

  3. #13
    Location
    Albany, New York
    Posts
    456
    Smile
    Thank you Mary.

    Modifier 59 is not needed in this scenario based on code description.
    Karen Maloney, CPC
    Data Quality Specialist

  4. #14
    Location
    Woodland Hills, CA
    Posts
    121
    Default
    Oh, ok, I was wondering about the usage of the mod 59. Would you please explain Mary?

    Thanks Mary and Karen,
    Lilit
    Last edited by HCCCoder; 01-09-2009 at 02:30 AM.
    CPC CCS
    "The true way to render ourselves happy is to love our work and find in it our pleasure."

  5. #15
    Location
    Jacksonville, FL
    Posts
    63
    Unhappy Help!! OP report attached!
    Procedure performed:
    Lumbar radiofrequency denervation L2-L3, L3-L4,
    L4-L5, and L5-S] bilateral, sacroiliac joint
    radiofrequency denervation x4 bilateral.


    DESCRIPTION OF PROCEDURE:
    The patient was identified as Bob the Builder and was brought to the operating suite. After placing appropriate monitoring devices and intravenous lines, monitored anesthesia care was induced. The patient was placed in prone position on the operating table. Care was taken to make sure all bony prominences had gentle pressure. Care was taken to make sure the brachial plexus had normal pressure. The neck was carefully flexed in all planes. The patient was then prepped and draped in the usual sterile manner in the lumbar field. Under fluorometric guidance, the L1-L2 facet joint was localized and injected with 0.5 cc of 0.5% Marcaine and then heated to 80”C for 90 seconds. This was done at L2-L3, L3-L,4, L4-L5, and L5-Sl first on the right and left and then was done at the sacroiliac joint in four locations first on the right and then on the left.

    Physician wants to bill 64475 x 1 and 64476 x 19. (I KNOW this is SO wrong, but I'm confused between the 64475 and the 64622 code ranges.)

    Can anyone help me please?? Thanks SO much!

  6. #16
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by beckipoff View Post
    Procedure performed:
    Lumbar radiofrequency denervation L2-L3, L3-L4,
    L4-L5, and L5-S] bilateral, sacroiliac joint
    radiofrequency denervation x4 bilateral.


    DESCRIPTION OF PROCEDURE:
    The patient was identified as Bob the Builder and was brought to the operating suite. After placing appropriate monitoring devices and intravenous lines, monitored anesthesia care was induced. The patient was placed in prone position on the operating table. Care was taken to make sure all bony prominences had gentle pressure. Care was taken to make sure the brachial plexus had normal pressure. The neck was carefully flexed in all planes. The patient was then prepped and draped in the usual sterile manner in the lumbar field. Under fluorometric guidance, the L1-L2 facet joint was localized and injected with 0.5 cc of 0.5% Marcaine and then heated to 80”C for 90 seconds. This was done at L2-L3, L3-L,4, L4-L5, and L5-Sl first on the right and left and then was done at the sacroiliac joint in four locations first on the right and then on the left.

    Physician wants to bill 64475 x 1 and 64476 x 19. (I KNOW this is SO wrong, but I'm confused between the 64475 and the 64622 code ranges.)

    Can anyone help me please?? Thanks SO much!
    Since the op note states denervation, you would count the actual number of nerves. In this case, you would report:

    64622-50 (L2)
    64623-50 x 4 (L3, L4, L5, S1)

    5 Nerves

    Count the number of nerves he/she injects, not the individual injections.

    Had this been a nerve block, you have would counted the levels

    In that case, you would have had:

    64475-50 (L2-L3)
    64476-50 x 3 (L3-L4 L4-L5 L5-S1)

    4 levels

  7. #17
    Location
    Jacksonville, FL
    Posts
    63
    Default
    Amazing, Rebecca! You've just helped me understand the difference. That light bulb just came on! You're awesome! Thanks for the help!

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