Ask Dr. Z

Since CPT 2020 added 64625 with note not to report in conjunction with 64635, we are not sure how to code sacroiliac joint denervation with radiofrequency lesioning of the L5 dorsal ramus and lateral branches of S1, S2, S3, S4 (using Simplicity III). Dx: bilateral sacrococcygeal spondylosis w/o myelopathy. "Procedure:...C-arm visualizing lateral inferior boarder of sacrum just lateral to S4 foramen... The needle contact the scrum bone the advanced lateral to S4 & other foremen but medial to the sij in cephalad direction. .. Simplicity III electrode inserted at entry point where spinal needle was placed...probe advanced maintaining contact with sacrum...Lesioning was carried out in the Simplicity III Program protocol at 80 degrees centigrade for 5 min. L5 Dorsal ramus RF: C-arm repositions... L5-S1 vertebra body squared. S1 superior articular process ID-ed. two 10 rf needle advanced to border of superior articular process and sacral ala. Motor stim done to 2 hz w/no motor recruitment...steroid injected. site lesioned 90 sec at 80 degree centigrade."