Neurology & Pain Management Coding Alert

Question: What CPT® code best represents radiofrequency ablation of a painful abdominal anterior cutaneous nerve at the site of a healed ventral hernia incision?

Florida Subscriber

Answer: CPT® includes several codes for varying specific somatic nerve destruction procedures. Currently there isn't a specific CPT® code for the anterior abdominal cutaneous nerves. However, CPT® does provide 64640 (Destruction by neurolytic agent; other peripheral nerve or branch) for standard radiofrequency of other somatic nerves and/or branches.

Tip: In many cases, the physician first performs an injection of local anesthetic to verify the source of the patient's pain. If the procedure report documents the temporary block, then you can submit 64450 (Injection, anesthetic agent; other peripheral nerve or branch). After determining that the diagnostic block successfully alleviated the patient's pain, the physician may elect to perform a neurolytic destruction during another visit; that's when you'll report 64640.