# RFA-Help ASAP



## NESmith (Jul 30, 2010)

Please do not take offense but I need an answer from someone who is certified in Pain Management. I have a provider that will not take any one's word except from someone who is certified in Pain. My question is we have a provider who si doing RFA's of the left L4, L5, S1, S2, S3 and SA. He is billing 64622 x 1 and 64623 x 4. The other Pain provider states this is incorrect and that he should be billing CPT code 64640 for S1, S2, S3 and SA. Please help me with this because I am fairly new with Pain Management. I would also need something in writing to support what I am saying.


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## shearenea (Aug 5, 2010)

Well I have been coding anesthesia for several years but we don't do pain management, but looking at your case I would code them according to how the 1st doctor was doing it already. You will have to post what the outcome is.


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## mitchellde (Aug 5, 2010)

NESmith said:


> Please do not take offense but I need an answer from someone who is certified in Pain Management. I have a provider that will not take any one's word except from someone who is certified in Pain. My question is we have a provider who si doing RFA's of the left L4, L5, S1, S2, S3 and SA. He is billing 64622 x 1 and 64623 x 4. The other Pain provider states this is incorrect and that he should be billing CPT code 64640 for S1, S2, S3 and SA. Please help me with this because I am fairly new with Pain Management. I would also need something in writing to support what I am saying.




Did the  physician performed the destruction within the SI joint itself or to the nerves that innervate the SI joint. More than likely the procedure was for  the surrounding nerves
The paravertebral facet joint nerves don’t innervate the SI joint, and there are no paravertebral facet joints below the L5-S1 facet joint. Providers often perform destruction of some branches that innervate the SI joint (such as L5, S1, S2 and S3). These are not paravertebral facet joint nerves, so coding it as such is incorrect.
Report RF More Accurately with 64640 or 64999
I took this excerpt from an article written a few years back in the coding institute.


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