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Neurology & Pain Management Coding Alert

Reader Question:

Understand Levels and Sites for 64633-64636 Coding

Published on Sun Jun 24, 2012

Question: Coding instructions in CPT® state that when you bill 64636 you should "code first" 64635. I'm not sure it's correct to bill two primary level codes (such as 64633 and 64635) for the procedure. Can you clarify how to handle this? Connecticut Subscriber Answer: You should consider two factors when coding paravertebral facet joint nerve destruction: the facet joint level treated and single versus multiple destructions to that level. When the physician destroys the paravertebral facet joint nerves that innervate a cervical or thoracic joint, report 64633 (Destruction by neurolytic agent, paravertebral facet joint nerve[s] with imaging guidance [fluoroscopy or CT]; cervical or thoracic, single facet joint) for the initial (first level) destruction. Add +64634 (...each additional facet joint [List separately in addition to code for primary procedure]) for each additional cervical or thoracic level the physician destroys during that encounter. For the lumbar or sacral spinal region, start [...]
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