Q & A with Dr. Z: Radiofrequency Ablation Sacral Ala & Lateral Branches
by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
For the following dictation, what can be coded?
“Procedure: Fluoroscopy guided radiofrequency ablation at right sacral ala and lateral branches at S1, S2, and S3 (12 sites). Detail: Following informed consent, and with the patient under general anesthesia, she was prepped and draped in usual sterile fashion. The skin and subcutaneous tissue were anesthetized. Following this I used a 22 gauge angulated 150 mm exposed tip needle at each level, correctly placing them under fluoroscopic guidance at right sacral ala and lateral branches at S1, S2, S3. After stimulating at each level without evidence of motor signs, I performed radiofrequency ablation at each site, heating the affected nerves to 80 degrees centigrade for 90 seconds. A total of 12 sites were heated and treated. I removed the needles and applied sterile dressings.”
Would it be coded as 64640 x 4 (for the levels) or 64640 x 12 (for the 12 sites)?
Answer:
In 2020, I would code this as 64625-50 (RF ablation of nerves innervating the SI joint, which is a new code for 2020) one time. In 2019, it would be reported with 64640-50 x 4.
Updates for Interventional Radiology, Cardiology, Cardiothoracic Surgery, and Vascular Surgery
This ZHealth Publishing webinar highlights the extensive changes to interventional radiology, cardiology, cardiothoracic surgery, and endovascular surgery that take effect in 2020. In this webinar, we discuss the code updates and include numerous examples of their appropriate use. This high level overview of the 2020 coding updates goes into great detail where appropriate. Learn more here.
