There is new therapy the Orthopedic providers would like to use. It is called Iovera (Non-Opioid nerve block). It is the temporary destruction of the nerve with cryotherapy. The Drug company has advised the providers to bill 64640. However, this clearly states the destruction of the nerve with heat. Wouldn't the following Category III codes to be the better choice:
Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve
Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve
Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)
Cryoanalgesia, correct reporting
CPT Assistant, October 2017 Page: 9 Category: Frequently Asked Questions
Surgery: Nervous System
What is the appropriate code to report cryoanalgesia applied to peripheral nerves (ie, genicular), as well as cryoanalgesia for postthoracotomy pain?
These services are reported the same way as other neurolytic destruction procedures, ie, depending on the anatomical location of the nerve(s) to be treated (eg, code 64630, Destruction by neurolytic agent; pudendal nerve; code 64632, Destruction by neurolytic agent; plantar common digital nerve; code 64640, Destruction by neurolytic agent; other peripheral nerve or branch).
Kathy J. Washburn, CPC
Coding & Documentation Improvement Specialist
Marshall Medical Center1100 Marshall Way | Placerville, CA | 95667Office: 530.626.2825 Ext. 2825
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