# another scar neuroma question



## PEH350 (Apr 22, 2009)

Our Pain Mgmt group performs cryoablation of scar neuromas on an outpt basis.  They currently use the CPT of 64640.  A scar neuroma is the scar band, not a nerve.  What is the correct CPT code for cryo of scar neuroma on the forearm?

Thanks.


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## marcialsj (Apr 22, 2009)

This is what we received from CPT:

Inquiry Question:
What is the best code for a Scar Neuroma Injection?
11900?
64640?
64999?

Please be advised that your inquiry was forwarded to our CPT Advisor representing the American Academy of Pain Medicine for review. Based solely upon the information provided in your electronic inquiry, from a CPT coding perspective and per our CPT Advisor, ?It would be appropriate to report a nerve block injection code for the anatomic site involved or a destruction code if neurolysis is the goal.  Most specifically, CPT codes 64450, Injection, anesthetic agent; other peripheral nerve or branch, or 64640, Destruction bby neurolytic agent; other peripheral nerve or branch, for this injection(s), since these codes respectively address the additional work of an injection of an anesthetic agent (nerve block), neurolytic or sclerosing agent into the peripheral nerves.


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## PEH350 (Apr 23, 2009)

Thanks.  So my understanding based on the replies for the two questions pertaining to scar neuromas are this:

11900  for scar neuroma injection with an anesthetic agent

64640  scar neuroma destruction 

I am relatively new to Pain Mgmt area and really appreciate all the input from this board.


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## Zellerdh (Feb 1, 2010)

*scar neuroma injections*

I have been struggling with this one lately myself.  Recently had both an injection and a destruction by injuction and was not sure what to use.  After reading the responses posted here, I still am not 100% sure what codes were the right ones.  I believe the 64640 woud be correct for destruction, but is it the 64450 or the 11900 for the injection?  If the 11900 code is correct that would indicate a lesion being injected which then makes me wonder if I should use 17000 and +17003 for the destruction?  Very confusing  I code surgical procedures for anesthesia and our pain clinic has just started doing these injections in peds in the OR, so I'm stumped.  Thanks for any input that anyone has.


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