# 64640 vs 64999 for a saphenous nerve rfa



## calatv (Jan 10, 2019)

Hi,
Our provider performed a left saphenous nerve radiofrequency ablation. However, in his op notes, he states the radiofrequency was performed for 60 seconds at 60 degrees Celsius.

I know CPT guidelines state the following:

"Do not report 64633, 64634, 64635, 64636 for non-thermal facet joint denervation including chemical, low-grade thermal energy (<80 degrees Celsius), or any form of pulsed radiofrequency. To appropriately report any of these modalities, use 64999."


I may be splitting hairs, but 64640 isn't listed in that restriction. So would we be able to code 64640? Or go with 64999?

Any guidance would be greatly appreciated! Thanks!


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## dwaldman (Jan 14, 2019)

I agree they don't address peripheral nerves.

I noticed UnitedHealthcare doesn't necessarily use the AMA parenthetical instruction and describe as below: 

https://www.uhcprovider.com/content...dical-drug/ablative-treatment-spinal-pain.pdf

Thermal Radiofrequency Ablation is defined as follows:
 Temperature ≥60° Celsius; and
 Duration of ablation ≥40 seconds; and
 Confirmation of needle placement by fluoroscopic guided imaging

Pulsed Radiofrequency Ablation: Technique that delivers intermittent bursts of current, instead of continuous
current, using a probe temperature of 42°-45° Celsius (Hayes, 2016a; updated 2017).


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