Neurology & Pain Management Coding Alert

You Be the Coder:

Ablation Codes for Multiple Destructions

Question: If a patient reports to the provider for scheduled spinal radiofrequency (RF) ablation, how should I code for the service?

Minnesota Subscriber

Answer: You'll need some more information, from either the encounter notes or the provider, before making your decision.

You have four codes to choose from when coding spinal RF ablation, based on the spinal area and number of joints treated in that spinal area:

  • 64633 - Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint 
  • +64634 - ... cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)  
  • 64635 - Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint 
  • +64636 - ... lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure).

Do this: Check the encounter notes and ask the providing specialist for the exact locations of each spinal RF ablation you code.