Eli's Rehab Report
Use Unlisted for Impar Ganglion Blocks
Question: I've been coding impar ganglion blocks with unlisted-procedure CPT 64999 . Is this the best choice?
Florida Subscriber
Answer: Most practices report this procedure with 64999 (Unlisted procedure, nervous system) to mostly commercial payers or workers' compensation and are successful. The impar ganglion is not anatomically located in the thoracic or lumbar region, so there isn't a valid CPT code for this block. You shouldn't choose a "close or approximate" code any longer, CPT instructions say.
Keep in mind: Using an unlisted-procedure code requires more work because besides sending along your provider's documentation of the service, you should send the payer a brief letter describing the procedure performed in layman's terms, the medical necessity for this unlisted procedure, and include a valid CPT code that the unlisted procedure is comparable to.
An unlisted procedure often takes more time to process. Many Medicare carriers request that you send all claims electronically and wait for carriers to request any additional information rather than initially submitting a paper claim.
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