Linda Moore asked:
I need some help coding this as physician outpatient charge.
approximately 2.5 mL of 4% dehydrated alcohol with epinephrine and Xylocaine a block injection was given around the neuroma type pain on the posterior aspect of the right and left Achilles tendon. This was a sclerosing type injection to disrupt and destroy the nerve endings to help reduce the pain and discomfort. This is a peripheral nerve destruction; the normal CPT Code is 64640; and it is a peripheral nerve; not a digital nerve because there is a different code for a digital nerve more in the forefoot.
Answer:
I like 64640 for this one
64640 - Destruction by neurolytic agent; other peripheral nerve or branch
Destruction of a nerve is performed to treat chronic pain and may be performed by injection of a chemical neurolytic agent or using thermal; electrical or radiofrequency techniques. The most common technique used today is radiofrequency destruction; although the other techniques may also be used for certain pain syndromes. Prior to the destruction procedure; an electrode needle is introduced through the skin and advanced toward the targeted neural tissue. The needle is connected to a generator for motor and sensory testing performed to ensure that the needle is correctly positioned at the nerve responsible for the pain. Once the correct nerve pathway has been identified; the nerve is destroyed. If a chemical agent is used; the chemical agent is injected along the nerve pathway. Neurolytic chemical agents include: phenol; ethyl alcohol; glycerol; ammonium salt compounds and hypertonic or hypotonic solutions. Thermal or electrical modalities involve the use of a probe or needle that is
inserted through the skin and activated to produce heat and destroy nerve tissue. To perform radiofrequency nerve destruction; an electrode needle is introduced through the skin and advanced toward the targeted neural tissue. The electrode is adjusted as needed until correct positioning is achieved. The radiofrequency device is then activated and an electric current generated that produces heat at the tip of the electrode and destroys the targeted nerve tissue. Use 64640 for destruction of a peripheral nerve or branch that does not have a more specific code listed.
I need some help coding this as physician outpatient charge.
approximately 2.5 mL of 4% dehydrated alcohol with epinephrine and Xylocaine a block injection was given around the neuroma type pain on the posterior aspect of the right and left Achilles tendon. This was a sclerosing type injection to disrupt and destroy the nerve endings to help reduce the pain and discomfort. This is a peripheral nerve destruction; the normal CPT Code is 64640; and it is a peripheral nerve; not a digital nerve because there is a different code for a digital nerve more in the forefoot.
Answer:
I like 64640 for this one
64640 - Destruction by neurolytic agent; other peripheral nerve or branch
Destruction of a nerve is performed to treat chronic pain and may be performed by injection of a chemical neurolytic agent or using thermal; electrical or radiofrequency techniques. The most common technique used today is radiofrequency destruction; although the other techniques may also be used for certain pain syndromes. Prior to the destruction procedure; an electrode needle is introduced through the skin and advanced toward the targeted neural tissue. The needle is connected to a generator for motor and sensory testing performed to ensure that the needle is correctly positioned at the nerve responsible for the pain. Once the correct nerve pathway has been identified; the nerve is destroyed. If a chemical agent is used; the chemical agent is injected along the nerve pathway. Neurolytic chemical agents include: phenol; ethyl alcohol; glycerol; ammonium salt compounds and hypertonic or hypotonic solutions. Thermal or electrical modalities involve the use of a probe or needle that is
inserted through the skin and activated to produce heat and destroy nerve tissue. To perform radiofrequency nerve destruction; an electrode needle is introduced through the skin and advanced toward the targeted neural tissue. The electrode is adjusted as needed until correct positioning is achieved. The radiofrequency device is then activated and an electric current generated that produces heat at the tip of the electrode and destroys the targeted nerve tissue. Use 64640 for destruction of a peripheral nerve or branch that does not have a more specific code listed.
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