# Rfa



## mray32 (Jun 1, 2009)

What are the requirements for billing 64622? Is heat a required component? Also, if a physician does an injection and applies radiofrequency but no ablation, what code is used for the radiofrequency? 64999? Any insight is helpful.


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## LTibbetts (Jun 3, 2009)

This is a description from my 3M software. Hopefully it will help:

64620-64640 (64620, 64622, 64623, 64626, 64627, 64630, 64632, 64640) 

These procedures are performed to treat chronic pain. The affected nerve is destroyed using chemical, thermal, electrical, or radiofrequency techniques, which may be used independently or in combination. These procedures are designed to destroy the specific site(s) in the nerve root that produce(s) the pain while leaving sensation intact. Generally intravenous conscious sedation is used during the initial phase of the procedure so that the patient can assist the physician in identifying the site of pain and the correct placement of the neurolytic agent, and local anesthesia is administered during the destruction phase of the procedure. Using separately reportable fluoroscopic guidance, a needle is inserted into the affected nerve root. An electrode is inserted through the needle and a mild electrical current is passed through the electrode. The current produces a tingling sensation at a site on the nerve. The electrode is manipulated until the tingling sensation is felt at the same site as the pain. Once the physician has determined that the electrode is positioned at the site responsible for the pain, a local anesthetic is administered and a neurolytic agent applied. Chemical destruction involves injection of a neurolytic substance (e.g., alcohol, phenol, glycerol) into the affected nerve root. Thermal techniques use heat. Electrical techniques use an electrical current. Radiofrequency, also referred to as radiofrequency rhizotomy, uses a solar or microwave current. Report 64620 when the site is the intercostal nerve. Report 64622-64623 when one or more lumbar/sacral paravertebral facet joint nerve is treated and 64626-64627 when the treatment is at the cervical/thoracic facet joint level. Report 64630 for the pudendal nerve, 64632 for the plantar common digital nerve, and 64640 for other peripheral nerves or branches.


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## KimberlyLanier (Jul 20, 2009)

On the 64620 if the doctor does different levels at the Intercoastal Nerve can you code more than once using this code?

Kimberly


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