# Ganglion impar block



## lmcmillan

I need help coding for a ganglion impar block.  I am looking at 64520 but am unsure. Is there a better code to use? 
Lynnett


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## amitjoshi4

Look at 64505 and 64510. It will also help. But you are under correct series of codes

Thank You


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## marvelh

The ganglion impar is found anterior to the coccyx and is the only unpair sympathetic ganglion.  Commonly it is injected for diagnosis of rectal pain due to tumor, trauma, etc. 

Currently there is no CPT code for either an injection of destruction of the ganglion impar.  Per Sept 2007 CPT Assistant: report 64999 for an injection of the ganglion impar.


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## amitjoshi4

Thank You Marvelh for your contribution. Here is the cpt assistant article.

*Surgery: Nervous System
CPT Assistant September 2007, Volume 17, Issue 9, pages 10-11
Question: 
What is the appropriate CPT code to report for a ganglion impar sympathetic block?
Answer: 
*Code _64999, Unlisted procedure, nervous system_, should be reported. When reporting an unlisted code to describe a procedure or service, it will be necessary to submit supporting documentation (eg, a procedure report) along with the claim to provide an adequate description of the nature, extent, and need for the procedure and the time, effort, and equipment necessary to provide the service.


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## glassa

Is that CPT Assistant for advice on billing Ganglion Impar Injections still accurate?


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## Smiths1

*Ganglion Impar Block*

CPT 2009 recommended code 64517 to be reported for this procedure versus an unlisted code 64999.  Is this still accurate currently?


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## dwaldman

In response to the following posts

Is that CPT Assistant for advice on billing Ganglion Impar Injection still accurate?

CPT 2009 recommended code 64517 to be reported for this procedure versus an unlisted code 64999. Is this still accurate currently? 

_________________________________________________________
 CPT Assistant articles  over the years have provided concrete understanding in proper code assignment and compliant billing. With gudiance from the AMA via CPT Assistant or CPT Network, published articles are straight from the source, which provide a better understanding of the codes within the CPT Manual. With changes in healthcare everyday and with such future requirements-- EMR/EHR, E presribing, Quality measures reporting, there is not a reason to make it more difficult than it needs to be. If there is CPT Assistant article that states it is unlisted, until otherwise specified that is considered the most appropriate code to bill.  CPT 2009 did not state to use hypogastric plexus block for this procedure but that procedure could be compared in a cover letter for the pricing or requested reimbursement when you bill the insurance company the unlisted code.


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## abelzung

*alta*

what about radiofrequency


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## abelzung

above


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## COMPauditor

Is 64999 still the only acceptable code for an Impar Ganglion Block?


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## Melissa Harris CPC

Yes it is.  

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


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## COMPauditor

That is what I was afraid of, my docs are not too fond of unlisted codes.  Thanks for the reply!


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## dwaldman

COMPauditor, 64999 is the only code per AMA CPT Assistant that can be reported for the ganglion impar block.

Surgery: Nervous System
CPT Assistant September 2007, Volume 17, Issue 9, pages 10-11
Question: 
What is the appropriate CPT code to report for a ganglion impar sympathetic block?
Answer: 
Code 64999, Unlisted procedure, nervous system, should be reported. When reporting an unlisted code to describe a procedure or service, it will be necessary to submit supporting documentation (eg, a procedure report) along with the claim to provide an adequate description of the nature, extent, and need for the procedure and the time, effort, and equipment necessary to provide the service.


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