# Left Greater Trochanter RFA Question



## Melissa Harris CPC (Jan 5, 2016)

Hello,

I was wondering if you can help me with this one.

The patient had a left greater trochanter RFA.  Lesioning was performed in 4 quadrants by repositioning the needle in the 12, 6,9 and 3 o'clock positions. 

Would this be 64640 x 1 or 64640 x 4?

Thank you!
Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management


----------



## dwaldman (Jan 5, 2016)

I know this is not the same anatomical region as the procedure in your questions but I think by reading the below, it lead me to believe that the concept for individual nerve non-pulsed ablation of sacroiliac joint per nerve can not be applied to all procedures that don't have the same published guidance. Although that doesn't answer question, I think if you were in the carrier's position would you release payment for 4 units for what is being described. 

AMA CPT Assistant November 2015 page 11

Frequently Asked Questions:Surgery: Nervous System

Question: When a physician injects the superior medial and lateral branches and inferior medial branches of the left genicular nerve, is code 64450 reported three times or just once for the left genicular nerve? 

Answer:It is appropriate to report code 64450, Injection, anesthetic agent; other peripheral nerve or branch, for the genicular nerve block of three branches of this nerve around the knee joint; however, code 64450 is reported just once during a session when performing the injection(s). Although one, two, or more injections may be required during the session, the code is reported only once, irrespective of the number of injections needed to block this nerve and its branches


----------

