# Stump Neuroma RFA



## kellit21 (Jul 17, 2014)

My physician performed an RFA on a lower extremity stump neuroma and is billing with 64640 along with 95873 for the guideance, but I know this is not correct. Can anyone help me with how to code this?


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## dwaldman (Jul 21, 2014)

CPT 95873 is designated to report with chemodenervation codes such as current codes extremity codes 64642-64645. CPT  95873 is not reported for radiofrequency ablation code CPT  64640. Below it is noted that they specifically state the code range of chemodenervation codes (64612-64614) that 95873 or 95974 can be reported with. Although this code can not be reported, NCCI does not bundle if fluoroscopic guidance was utilized (64640, 77002)

AMA CPT Changes  2006 

Two add-on codes were established in the Electromyography and Nerve Conduction Tests section for reporting needle EMG guidance with chemodenervation and electrical stimulation guidance with chemodenervation. Prior to the chemodenervation procedure, it is sometimes necessary to perform a more precise localization for needle placement before the chemical is injected. Therefore, the physician may perform electrical stimulation or needle EMG to achieve this localization. Code 95873 describes electrical stimulation and 95874 describes needle EMG. Either 95873 or 95874 should be reported, as appropriate, in conjunction with chemodenervation codes 64612-64614 when electrical stimulation or needle EMG is performed for guidance prior to injection of the chemical. Codes 95873 and 95874 should not be reported in conjunction with needle electromyography procedure codes 95860-95870. Codes 95873 and 95874 should never be reported together. Three parenthetical notes have been added following 95874 that instruct users on the proper use of these codes.


2014 Codes

95873 Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure)





64642 Chemodenervation of one extremity; 1-4 muscles




64643 each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedur


64644 Chemodenervation of one extremity; 5 or more muscles


64645 each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure)


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