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Rhizotomy Procedures 64622/23 and 64626/27

Catherine Posted Tue 22nd of November, 2011 20:41:56 PM

When billing lumbar/cervical non-pulsed radiofrequency facet denervation codes 64622/64623(lumbar)and 64626/64627 (cervical). Do you count the # of levels (L2-L3) injected, or the number of nerves/lesions.

SuperCoder Answered Tue 22nd of November, 2011 21:45:49 PM

You report 64622 (Destruction of neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, single level) per destruction of each nerve.
Facet nerve destruction codes 64622-64627 refer to individual nerve destruction.
Facet joint nerve injection codes 64490-64495, by contrast, describe facet joint injections and are based on facet joint level.
Your provider performs an injection of the left L3 and L4 medial branch (facet joint) nerve; report 64493 (Injection[s], diagnostic or therapeutic agent, paravertebral facet [zygapophyseal] joint [or nerves innervating that joint] with image guidance [fluoroscopy or CT], lumbar or sacral; single level).
If your provider performs a radiofrequency destruction of the L3 and L4 medial branch nerves, however, you would report 64622 and +64623 (… lumbar or sacral, each additional level [List separately in addition to code for primary procedure]).

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