Neurosurgery Coding Alert
Be Specific for Coccygeal Nerve and Ganglion Impar Block
Question: Our physician did a radiofrequency ablation (RFA) of the coccyx. This technique was a non-pulsed procedure into the coccyx disc. Can we submit code 64999 for this procedure? Is code 64450 also a good possibility? Which of the two makes the most appropriate code for this procedure?
Nebraska Subscriber
Answer: From the description shared, it is likely that your physician has done a ganglion impar block. According to the CPT® Assistant, you should code a ganglion impar block as 64999 (Unlisted procedure, nervous system).
Differentiate coccygeal nerve block: You might be able to report a coccygeal nerve block with 64450 (Injection, anesthetic agent; other peripheral nerve or branch) if your physician injected the coccygeal nerve. This code does not apply to RFA destruction of the sacrococcygeal joint.
Be specific for the coccygeal nerve: Without a specific nerve or branch documented as the target, you’ll need to report 64999 instead of 64650.
Sacrococcygeal disc: The sacrococcygeal disc is a thin plate of fibrocartilage interposed between the sacrum and coccyx. The ganglion impar lies anterior to the sacrococcygeal disc.
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