# Need Help with Radiofrequency Coding



## Cindyrev67 (Jun 29, 2012)

Our office continually gets denials for radiofrequencies.  I'm hoping someone can help with coding the L5-S3 joints.

Right sacroiliac joint radiofrequency ablation (Right, L5, S1, S2, S3 lumbar joint medial branch radiofrequency procedure).

I've been reporting it as

64635 L5-S1
64636 S1-S2
64636-59 S2-S3

Should I report it like this instead?

64635 L5-S1
64640 S1-S2
64640-59 S2-S3

Any help I can get will be greatly appreciated!


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## dwaldman (Jun 30, 2012)

Below is from June CPT Assistant,  

If it was the lateral branches innervating the SI joint I would use the below guidance of 64640 per individual treatment


June AMA CPT Assistant  2012 page 15
Frequently Asked Questions:Surgery: Nervous System

Question: May code 64640 be reported for each individual peripheral neurolytic nerve destruction procedure performed at the L5, S1, S2, and S3 nerves? 

Answer: Yes. When performing individually separate nerve destruction, each peripheral nerve root neurolytic block is reported as destruction of a peripheral nerve, using code 64640, Destruction by neurolytic agent; other peripheral nerve or branch. In this instance, for peripheral nerve root neurolytic blocks (destruction) of L5, S1, S2, and S3, code 64640 should be reported four times. The coder should append modifier 59, Distinct Procedural Service, to the second and subsequent listings of code 64640 to separately identify these procedures.


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