Eli's Rehab Report

Question: Which codes should I report for cryoneu-rolysis of the thoracic intercostal nerves at T9, T10, T11 and T12 under fluoroscopic guidance?

Indiana Subscriber

Answer: You should report one unit of 64620 (Destruction by neurolytic agent, intercostal nerve) for  each nerve that the physician injects. Most carriers do not require you to append modifier -51 (Multiple procedures) or reduce your fee for subsequent injections because the insurer will automatically make a reduction if necessary. But some carriers do require modifier -51, so check with your insurer before submitting these claims.

You should report 76005 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint], including neurolytic agent destruction) if your physician provides both the professional and technical portions of the fluoroscopy. If your practice does not own the fluoroscopy machine or employ the fluoroscopy technician, you should append modifier -26 (Professional component) to 76005.