# Genicular Nerve Rhizotomy



## Jamie Dezenzo (Feb 18, 2016)

I have a Medicare patient and verifying 64640 billed once or 3 times??? (superomedial, inferomedial and superolateral)

Per AMA 11/15 regarding just the block 64450 bill one time only

Thanks for any updated info!

Jamie


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## Melissa Harris CPC (Feb 17, 2017)

For the RFA you can bill 64640 three times because you are burning each branch of the nerve.  This was confirmed at the recent Pain management seminar.

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain management


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## marvelh (Feb 21, 2017)

Per Medicare 2017 NCCI Manual:
_If a physician injects the superior medial and lateral branches and inferior medial branches of the left genicular nerve, only one UOS of CPT code 64450 (Injection, anesthetic agent; other peripheral nerve or branch) may be reported regardless of the number of injections needed to block this nerve and its branches._

It is highly likely that Medicare contractors will take that stance that 64640 should be reported with 1 unit of service rather than three for this procedure.


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## Jamie Dezenzo (Feb 23, 2017)

Yes thank you I did see in NCCI Manual and made note


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