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coding abliation and rhizotmy

Victoria Posted Wed 20th of November, 2019 12:40:37 PM
What cpt codes would I use for FLUOROSCOPICALLY GUIDED RIGHT-SIDED L2, 3, AND 4 MEDIAL BRANCH ABLATION - L3-4 AND L4-5 RIGHT-SIDED FACET RHIZOTOMY?
SuperCoder Answered Thu 21st of November, 2019 07:17:29 AM

Hi Victoria,

 

Thanks for your question.

 

Radiofrequency ablation (RFA) and rhizotomy are the same thing. Codes 64635 and 64636 should be reported per joint, not per nerve.

 

So, you should report codes 64635 x1 (for L2-L3) and 64636 x2 (for L3-L4 and L4-L5). Fluoroscopy is included in these procedures and should not be reported separately.

 

Please feel free to write if you have any question.

 

Thanks

Victoria Posted Thu 21st of November, 2019 10:17:07 AM
if done bilaterally we can bill with modifier 50 correct?
SuperCoder Answered Fri 22nd of November, 2019 06:51:44 AM

Yes, for bilateral procedure, modifier 50 may be appended.

 
Moreover, please consider number of units for 64636 as 1 instead of 2.
 
The correct coding should be 64635 x 1 for the L3-L4 facet joint (L2 and L3 medial branches) and 64636 x 1 for the L4-L5 facet joint (innervated by the L3 and L4 medial branches).
 
Hope this helps.
 
Thanks.

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