Please note this question was answered in 2023. The coding advice may or may not be outdated.
Lumbar Sympathectomy w/ Alcohol
Question:
Would the following be coded as 64640 or 64999? The procedure was performed for severe debilitating pain.
"Two 22 gauge Chiba needles were advanced anterior to the vertebral body at the L2-3 level lateral to the aorta under CT guidance. A total of 10 mL dilute contrast material was then injected and repeat imaging obtained. Next, a total of 10 cc of alcohol were injected in each Chiba needle for a total of 20 cc for a lumbar sympathectomy. The needles were flushed and then removed. Follow-up CT was obtained to identify any complications. Successful needle placement anterior to the L2-3 vertebral body level at the lumbar sympathetic nerve complexes with contrast seen in the region of the nerve complexes crossing the midline. Successful alcohol injection for a lumbar sympathectomy."
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