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Anesthesia Coding Alert

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Cryoablation for Neurolysis

Published on Thu Sep 09, 2004

Question: How should I code bilateral occipital neurolysis with cryoablation? Also, how should I code cervical median descending branch nerve neurolysis via cryoablation (for C5, C6, C7)?

Minnesota Subscriber

Answer: Code each injection of the cervical median nerve neurolysis via cryoablation separately. Report CPT Code 64626 (Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level) and +64627 (... cervical or thoracic, each additional level [list separately in addition to code for primary procedure]) twice (for the second and third injections), or report them on separate lines with C5, C6 and C7 designations beside the codes.
 
Some coders suggest appending modifier -51 (Multiple procedures) to the third injection to distinguish it from the second, but other coders steer clear of this because add-on codes such as 64627 are modifier -51 exempt.
 
Code the occipital neurolysis with 64640 (Destruction by neurolytic agent; other peripheral nerve or branch). Be sure to append modifier -50 (Bilateral procedure).
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