CPT^® 64625, Under Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) Procedures on the Somatic Nerves

The Current Procedural Terminology (CPT^®) code 64625 as maintained by American Medical Association, is a medical procedural code under the range - Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) Procedures on the Somatic Nerves.

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Summary

The provider destroys the nerves innervating (supplying) the sacroiliac joint with radiofrequency ablation, that is, the use of heat produced by focused radio waves (a type of electromagnetic wave) to destroy areas of abnormal, damaged, or diseased tissue.

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Help which code should I use?

Which code should I use for the below op note, 64635 or 64625? I really think is should be 64625, but my manager feels it should be the 64635 since the note states the provider denervated the L5 face... [ Read More ]

UHC MEDICARE/64625

I wanted to let you know that I was able to get my Medicare recoupment claims overturned. Per my provider rep, "[I]After further review, I am going to clone this issue and overturn the Medicare cla... [ Read More ]

UHC MEDICARE/64625

[QUOTE="bdegeronimo, post: 501569, member: 293824"] Hello-all of our 64625 claims to UHC Medicare, Community Plan and Choice Plan are being recouped as well. Medicare does not have a LCD for the stat... [ Read More ]

UHC MEDICARE/64625

[QUOTE="GMMTimmons, post: 499440, member: 758507"] We have had issues with billing 64625 to UHC Medicare of Oklahoma. They paid these in 2020 and are now recouping and denying all 2021 claims. DX used... [ Read More ]

UHC MEDICARE/64625

We have had issues with billing 64625 to UHC Medicare of Oklahoma. They paid these in 2020 and are now recouping and denying all 2021 claims. DX used is M47.818. Medicare Oklahoma pays these with no i... [ Read More ]

64625 How to bill?

[QUOTE="afaustina1, post: 492462, member: 444082"] Hi, you are correct that 64635 and 64625 cannot be billed together. I do use modifier 59 for RF of facet joints to indicate additional or separate a... [ Read More ]

64625 How to bill?

[QUOTE="nyckimmie, post: 477796, member: 103486"] Hi, I too am wondering about adding mod 59 to 64635. a different area would fit the criteria for mod 59 but any coding advice I come across (as well a... [ Read More ]

RFA Sacroiliac joint, L5, S1, S2 and S3

[QUOTE="mah3434, post: 466804, member: 244400"] Which place of service are you billing this in? We are getting denials stating it is not performed in the correct place of service. [/QUOTE] So we are L... [ Read More ]

Please help..... SI RFA and Genicular RFA Medicare Advantage plans

I am having a lot of issues from Aetna Medicare not covering the 64451, 64454, 64624 and 64625, stating that these codes are experimental and investigational. However they are a payable and covered co... [ Read More ]

Does anyone have any suggestions on coding 64625 along with 64635?

Thank you for your review, this is a tricky report. I was thinking injection was also at L4/L5 which would lead to code 64635 along with 64625 for sacral ala level.... [ Read More ]

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