november 2015

Pain Management Injections — 2016 CPT Coding Alert

Changes to the guidelines in the “DESTRUCTION BY NEUROLYTIC AGENT” section of the 2016 CPT manual may now require your physician’s to provide more specific documentation when dictating the procedures described by CPT codes 64633-64636-Destruction by neurolytic agent, paravertebral facet joint nerve(s).

To be more specific the guidelines now state — “Do not report 64633, 64634, 64635, 64636 for non-thermal facet joint denervation including chemical, low grade thermal energy (<80 degrees Celsius), or any form of pulsed radiofrequency. To appropriately report any of these modalities, use 64999.”

For the physician it means that they must dictate the temperature to which the radiofrequency probe is being heated if they are already not doing so and for the coder they would report the unlisted CPT code if the heating is less than 80 Celsius. Many Medicare LCD’s already have this stipulation in place as part of their utilization guidelines.

Now is the time to pass this information along to your providers so that they are aware of this guideline and changes can be implemented prior to January 1, 2016.


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