# pain management injection



## carriep9829 (Nov 20, 2009)

Hi! One of our Drs performed radiofrequency ablation of the lumbar sympathetic nerves on the right side at L2, L3, and L4. I was having trouble trying to find an appropriate code. I was looking at 64640, but i'm not sure if that would be the right choice or if I should go with the unlisted code 64999? 

thanks for your help! Have a great weekend!


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## purinoski (Nov 20, 2009)

*Pain Management Injection*

Just remember that ASCs cannot use unlisted codes.  Hope that helps you to determine what to use.


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## carriep9829 (Nov 20, 2009)

ok thanks


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## bmorin (Nov 23, 2009)

64622 would be more appropriate and 64623 for each additional, with rt and lt modifiers. Hope that helps.


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## ASC CODER (Nov 23, 2009)

were exactly does it say ASC's can't use unlisted? I believe they can. They just don't get paid more than half the time...


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## evelasco (Nov 26, 2009)

*pain mgt*

i will use 64622-50 and 64623-50 but be careful there is a lcd on these codes with medicare.


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## brockorama01 (Jan 15, 2010)

As a pain management billing junkie, you cannot use 64622 for RF of Lumbar Sympathetic Nerves.  Lumbar Sympathetic Nerves are completely different than facet/medial/paravertebral nerves.  64640 won't help either since sympathetic nerves aren't peripheral nerves.  Your only hope is 64640 x 3.

Brock Berta, CPC
Junkie


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## carriep9829 (Jan 18, 2010)

ok, thanks for your help!


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