Neurology & Pain Management Coding Alert

Question: Our pain management specialist administered a phenol injection and performed radiofrequency on the ilioinguinal nerve. Can I bill code 64640 twice?

Nevada Subscriber

Answer: The units of service for 64640 (Destruction by neurolytic agent; other peripheral nerve or branch) focus on each separate and distinct peripheral nerve or branch. Because of this, code according to the distinct nerves or branches treated, not the number of injections or the neurolytic agent used.

Example: The physician uses RF to ablate the ilioinginal nerve and the greater occipital nerve. You can report two units of 64640 on the same line, or report 64640 on two separate lines (depending on the payer's preference). However, if the physician used two different neurolytic agents to destroy a single nerve, you would report only one unit of service instead of two.