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L2-L5 Medial Branch Nerve Radiofrequency Ablation

Date: Feb 18, 2020

Question:

I am looking for some clarification on coding this. Would it be 64635 (L2-L3), 64636 x 3 (L3-L4, L4-L5, L5-sacral ala) or 64635, 64636 x 2, 64640? They all say medial nerve in the header and the procedure report. "The target for the L2, L3, and L4 medial branch nerves was the junction of the transverse process and the superior articulating process of the L3, L4 and L5 levels respectively. The target for the L5 medial branch nerve or the L5 dorsal ramus nerve was the junction of the superior articulating process and the sacral ala. An appropriate skin entry site was identified after adjusting the fluoroscope to facilitate approaching the medial branch nerve target from a lateral and causal direction. The skin and subcutaneous tissues were the anesthetized. Through this numb and clean area of skin a 16 gauge 10 cm RFA probe with 10MM active tip was advanced under intermittent fluoroscopy until contact with the target was made."

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