# Alcohol Dehydrated 1mL for Mortons Neuroma



## tamaras (Oct 13, 2009)

Hi,I hope someone is able to help me with this. I can not find a HCPCS code for Alcohol Dehydrated 1 mL 10 amps/CT. The podiatrist I work for said it is used instead of Kenolog for Mortons Neuroma, it helps to minimize or desolve tissue and help with scarring. I guess it's mixed with Lidocane for Sclerosing.
Anyone had to use this product???????? Thanks in advance for any info given.


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## Lisa Bledsoe (Oct 13, 2009)

We do and as far as I know it is not billable.


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## TammyHF (Oct 14, 2009)

There is not a dehydrated alcohol HCPC code but there is a CPT code. CPT 64632 Destruction by neurolytic agent; plantar common digital nerve.


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## Lisa Bledsoe (Oct 14, 2009)

Isn't the correct code for Morton's Neuroma injection 64455?


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## TammyHF (Oct 15, 2009)

There are two separate injection codes for Morton's neuroma one for injection and one for destruction. The frist one is for steroid or anesthetic CPT 64455 Injection(s), anesthetic agent and/or steroid, plantar digital nerve(s) (eg, Morton's neuroma). The second one is for destruction or dehydrated alcohol injection CPT 64632 Destruction by neurolytic agent; plantar common digital nerve.


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## Lisa Bledsoe (Oct 15, 2009)

Thanks for the reminder Tammy - I had forgotten about that new code this year!  Luckily I had put it in a memo at the beginning of the year to my podiatrist.  I double checked and she has been using it


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## karasilvers (Dec 15, 2009)

We use the code 64640.  We get paid well and have only had one problem using it.  Now, with the fee changes for 2010, the pay is going down, but it still pays the best.


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## TammyHF (Dec 16, 2009)

According to Medicare guidelines CPT 64632 for destruction by neurolytic agent of the  is the corrected CPT to bill for a Morton's neuroma and CPT 64455 is for anesthetic agent and/or steroid for a Morton's neuroma. In guide line for Medicare it specifically states not to use 64640 for a Morton's neuroma.

From WPS Final Comments for Injections-Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma: Morton's neuromas injections do not involve the structures described by CPT codes 20550 and 20551 or direct injection into other peripheral nerves but rather the injection of tissue surrounding a specific focus of inflammation on the foot. These therapies are not to be coded using CPT codes 20550, 20551, 64450, or *64640*. Most specifically, the provider must not bill CPT codes 64450 or *64640* for these injections, since those codes respectively address the additional work of an injection of an anesthetic agent (nerve block), eurolytic or sclerosing agent into relatively more difficult peripheral nerves, rather than that involved in an injection of relatively easily localized areas. Morton's neuroma is included in the description of CPT code 64455 in the CPT manual.


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## kmmiller4476@gmail.com (Oct 7, 2010)

*Pelvic Cyst Alcohol Sclerosing*

What CPT code do I use?


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## tammster (Oct 8, 2010)

The package insert for the alcohol says that a concentration of 40% or greater is required for true destruction.  Therefore sclerosing injections (usually 4% to 6 %) are not billable as 64640 or 64632.  Instead, what you are performing is a therapeutic injection - 64450


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