Basivertebral nerve ablation cpt code New Pain Management 2020 Codes. Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 2-year results from a prospective randomized double-blind sham-controlled multicenter study. This procedure offers a minimally invasive approach to The sensory nerves within the center of the vertebral body converge to form the basivertebral nerve (BVN). BCBSA Ref. 3. McCormick, which is CPT code 64999 is to be used for pulsed radiofrequency ablation (CPT® Assistant, 2016) CPT Code Description 22899 Unlisted procedure, spine [when used to report the Intracept procedure] 64625 Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) 64633 Destruction by Currently the Intracept Intraosseous Nerve Ablation System is the only FDA approved system for this specific procedure. Intracept Intraosseous Nerve Ablation System (Relievant Medsystems Inc. (Note: Sometimes an EOB or MSN may display the CPT/HCPCS code with an associated modifier, which is represented by a dash and two characters. During the procedure, Dr. We did an intercostal RFA today so we would bill 64640. Basivertebral nerve ablation (BVNA) is a specific intervention targeting chronic axial low back pain from a vertebrogenic etiology, phenotypically identified by vertebral endplate damage, often described as Modic changes on Coding Guidance: Providers should refer to the applicable AMA CPT Manual to assist with proper reporting of these services. Schnapp, William et al. Use this code for each additional lumbar or sacral vertebral body treated after the first two at a session. 72 . Background . ) for the treatment of chronic low back pain. Jan 1, 2025 · Intraosseous radiofrequency ablation of the basivertebral nerve (e. The Intracept procedure specifically treats vertebrogenic pain, which is pain LCD: Intraosseous Basivertebral Nerve Ablation (L39644) IMPORTANT NOTICE: While some services or items may appear medically indicated for an individual, According to the local coverage article (LCA) A58405, CPT codes 64492 and 64495, as well as Category III codes 0213T-0218T, are all non-covered services for Medicare; however, Keywords: chronic low back pain, basivertebral nerve ablation, radiofrequency, endplate degeneration, modic changes, community practice setting INTRODUCTION Chronic low back pain (CLBP) is the most costly nostic code for vertebrogenic LBP or CPT codes for the procedure. How to use CPT code 64629 for thermal destruction of the basivertebral nerve, including its use cases, modifiers, and billing implications. Radiofrequency Ablation of Intraosseous Basivertebral Nerve for Vertebrogenic Lower Back Pain (e. Cooled radiofrequency ablation Basivertebral nerve radiofrequency ablation . It is a minimally invasive, outpatient procedure which targets a nerve located in the bones of the spine (vertebrae). New CPT 2020 Changes. LCD: Intraosseous Basivertebral Nerve Ablation (L39644) IMPORTANT NOTICE: While some services or items may appear medically indicated for an individual, According to the local coverage article (LCA) A58405, CPT codes 64492 and 64495, as well as Category III codes 0213T-0218T, are all non-covered services for Medicare; however, CPT codes CPT Codes CPT codes: Code Description 22526 Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including 2/2024 Policy statements on Intracept Procedure, intraosseuous basivertebral nerve ablation transferred to MP #485. Background/Overview Discogenic Low 2013 CPT Coding Changes for Nerve Conduction Studies – Effective January 1, 2013 . Examples The Current Procedural Terminology (CPT ®) codes and/or Healthcare Common Procedure Coding System (HCPCS) codes listed in this policy are for reference purposes only. Given the innovative nature of the Intracept Procedure, accurate billing and coding, understanding insurance Basivertebral Nerve Ablation Policy Number: 076 Commercial and Qualified Health Plans MassHealth Medicare Advantage Authorization Required X X No Prior Authorization Authorized CPT/HCPCS Codes Code Description 64628 Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first two vertebral bodies, lumbar or The International Society for the Advancement of Spine Surgery (ISASS) 2020 guideline – Intraosseous Ablation of the Basivertebral Nerve for the Relief of Chronic Low Back Pain concluded that “The procedure is supported by level 1 evidence including 2 RCTs demonstrating a statistically significant decrease in pain and an improvement in CPT Code Description Sacroiliac (SI) Joint Denervation 64625 Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance ( i. Examples The Intracept Procedure Intraosseous Nerve Ablation System is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 vertebrae for the relief of chronic low Abstract. These changes are explained as follows: We do a thermal, non pulsed radiofrequency ablation. CPT ® HCPCS; CDT ® (dental) ICD-10-PCS 64628 - CPT® Code in category: Thermal destruction of intraosseous This article explains the CPT code for ablation radiofrequency spinal nerve root at L3-L4, including its significance and what individuals should know about it. : MNG-008 CPT codes 22526, 22527, 22899, 64628, and 64629. Basivertebral nerve ablation (BVNA) is a specific intervention targeting chronic axial low back pain from a vertebrogenic etiology, phenotypically identified by vertebral endplate damage, often described as Modic changes on MRI. A: Sympathetic ganglion, B: Pedicle, C: Dorsal Root Ganglion, D: Sinuvertebral Nerve giving rise to branches D1: Ascending branch which goes intraosseous and give rise to Basivertebral peripheral nerve entrapment/compression (e. When nerves transmit pain signals in the presence of injury or disease, Best Practice Guidelines on the Diagnosis and Treatment of Vertebrogenic Pain with Basivertebral Nerve Ablation from the American Society of Pain and Neuroscience J Pain Res . ) Look for a Billing and Coding Article in the results and open it. 2024 Mar 17, 2024 · Learn about CPT code 64629 for thermal destruction of the basivertebral nerve, including its use cases, modifiers, and billing implications. , Intracept CPT code 64999 is to be used for pulsed radiofrequency ablation. @article{Stolzenberg2024BasivertebralNR, title={Basivertebral Nerve Radiofrequency Ablation (Intracept): Procedural Technique. This determination billing and coding article applies only to ablation of the intraosseous basivertebral nerve (BVN) within the vertebral bodies L3-S1. A curved cannula is introduced through the vertebral body near the trunk of the basivertebral nerve. The new Category I codes are: 64628: Thermal destruction of intraosseous basivertebral nerve, including all Intracept Intraosseous Basivertebral Nerve Ablation System Criteria for Chronic low back pain (CLBP) (Commercial and Medicare) 1. “A large number of patients are refractory to conventional pain measures, including steroid injections and medications,” explains Cleveland Clinic Pain Management specialist Sherif On the Medicare Coverage Database (MCD) you can use CPT/HCPCS codes to search for documents. This non-surgical procedure is often used to help patients find relief from nerve-related pain. CPT Code 64629, Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) and Chemodenervation Procedures method under imaging guidance to destroy an intraosseous basivertebral nerve. Radiofrequency ablation (RFA) is a minimally invasive procedure where radiofrequency energy is delivered to the basivertebral nerve. Home » Procedures » Basivertebral Nerve Ablation. , Intracept CPT code 64999 is to be used for Pulsed Radiofrequency Ablation (CPT 64628 Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 FDA has cleared Relievant’s Intracept System for the following Indications for Use: The Intracept Intraosseous Nerve Ablation System is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 vertebrae for the relief of chronic low back pain of at least 6 months This article provides an overview of the CPT code used for radiofrequency ablation of the lumbar region, explaining its purpose and how it is used in medical billing and coding. Take note of the word "branches". 2147/JPR. Patients with more than 6 months of low back pain with Modic Type I or II changes who were unresponsive to at least 3 months of conservative care underwent radiofrequency energy The good news is, we have a new code for this effective January 1, 2020. This code should be used in conjunction with appropriate imaging guidance, such as fluoroscopy or CT imaging, to ensure accurate placement of the cannula Two new CPT codes, 64628 and 64629, describe ablation of the basivertebral nerve first level and each additional level, respectively. It is important to note that the number of nerves injected for a single facet joint does not affect code selection. What is Vertebrogenic Pain? Vertebrogenic pain occurs when the vertebral endplates—where the vertebrae connect to the spinal discs—become damaged or inflamed In the United States, basivertebral nerve ablation is generally indicated for chronic lower back pain lasting more than 6 months, failure of nonsurgical management, and evidence on MRI of Modic type I and/or II changes at 1 or more vertebral bodies for levels L3-S1. CPT 64628 describes the thermal destruction of the intraosseous basivertebral nerve, including all imaging guidance, for the first two vertebral bodies in the lumbar or In either approach, the procedure would end with sinuvertebral and basivertebral nerve ablation as the final step. Lateral pectoral nerve ablation is performed over the mid-portion of the coracoid process from an anterior approach (Figure 3). In the past, other structures we Prior authorization will be required for the Intracept procedure (basivertebral nerve ablation, CPT codes 64628 and 64629), and CMS’ local coverage determination L39642 will be used for criteria. Radiofrequency denervation/ablation of the nerves innervating the sacroiliac joint for the treatment of sacroiliac (SI On the Medicare Coverage Database (MCD) you can use CPT/HCPCS codes to search for documents. 514 Note: CPT codes, descriptions and materials are copyrighted by the American Medical Association (AMA). . Please refer to the medical policy statement to determine the status of a given procedure. The traditional approach to basivertebral nerve ablation incorporates transpedicular access to the vertebral body, whereas . doi: 10. Two new CPT codes, 64628 and 64629, describe ablation of the basivertebral nerve first level and each additional nerve, respectively. }, author={David S. Reimbursement by a payer will depend upon the contract with the facility. 1. Feb 1, 2024 · Codes Number Description CPT . In conclusion, the CPT code for destroying the spinal nerve root at the L3-L4 level using radiofrequency ablation is 64640. Basivertebral nerve ablation represents a promising treatment for patients suffering from chronic low back pain of a vertebrogenic nature. There is insufficient evidence to determine the safety and effectiveness . Per the FDA approval document the Intracept System is “intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 vertebrae for the relief of Contraindications include being pregnant, having weakened cardiac or pulmonary function, having an implanted electronic medical device in the body (such as a pacemaker or defibrillator), being diagnosed with a systemic or local infection, or having an anatomy that could be damaged unintentionally while ablating the basivertebral nerve (based on Biacuplasty & Intraosseous Basivertebral Nerve Ablation Medicare Advantage Medical Policy No. Evidence for BVN Ablation. As of 1/1/20, United Healthcare states, "The following facet joint nerve ablation techniques are unproven and not medically necessary due to insufficient evidence of efficacy: Intraosseous radiofrequency ablation of the basivertebral nerve (e. The above medical necessity criteria MUST be met for the following codes Two new CPT codes, 64628 and 64629, describe ablation of the basivertebral nerve first level and each additional level, respectively. In addition, new prior authorization requirements added for the following: Long-term acute care; Skilled nursing facility care Basivertebral nerve ablation, also known as the Intracept procedure, is an innovative, minimally invasive treatment specifically designed to target this type of pain at its source. 51) and two Category I CPT codes for BVN ablation (64628 and 64629) and two Category I CPT codes for BVN ablation (64628 and 64629) et al. Spine J. Discover the benefits of AI-driven medical coding solutions, such as reduced coding errors and Jan 28, 2024 · Coding Guidance: Providers should refer to the applicable AMA CPT Manual to assist with proper reporting of these services. The code specifically Jan 28, 2024 · Article Text. The new Category I codes for the Intracept Procedure are: 64628: Thermal destruction of intraosseous basivertebral nerve, 4. Intraosseous basivertebral nerve ablation for the treatment of chronic low Nov 16, 2024 · AHA Coding Clinic ® for HCPCS - 2020 Issue 3; Ask the Editor Basivertebral nerve ablation. Becker, S, Hadjipavlou, A, and Heggeness, MH. S378544. When your physician is performing an RFA on Genicular nerves, use code 64624 (Destruction by neurolytic agent of genicular nerve branches). Question: What is the appropriate code to report for pulsed radiofrequency The damage to nerve tissue reduces its ability to transmit pain signals, thereby reducing pain sensation. the destruction of the intercostal nerve should be 64620 and the fluoroscopic guidance is inclusive to that code and not separately billed, per CPT instructions. DIGITAL FEATURES Given that basivertebral nerve ablation (BVNA) is a relatively new spinal procedure for the treatment of CLBP, and in view of the growing amount of research and clinical trials on the topic, we Basivertebral nerve ablation (BVNA) is a minimally invasive surgical treatment of vertebral pain performed similarly to vertebral augmentation and lumbar radiofrequency ablation, in the sense that it uses a transpedicular approach to the BVN bifurcation and delivers a high-frequency ablative lesion to interrupt nociceptive signaling from In the United States, basivertebral nerve ablation is generally indicated for chronic lower back pain lasting more than 6 months, failure of nonsurgical management, and evidence on MRI of Modic type I and/or II changes at 1 or more vertebral bodies for levels L3-S1. 64628 Thermal destruction of intraosseous basivertebral nerve, first 2 vertebral bodies Intraosseous Radiofrequency Ablation of the Basivertebral Nerve, 64628, 64629, m-sur225, m-surgery, Basivertebral nerve, Intracept, Radiofrequency ablation Created Date: May 22, 2020 · CPT codes 64633, 64634, 64635, and 64636 only apply to thermal radiofrequency ablation. Use this page to view details for the Local Coverage Article for Response to Comments: Intraosseous Basivertebral Nerve Ablation. There are a total of 249 new, 63 deleted and 93 revised CPT codes for 2022. Stolzenberg and Tariq Ziad Issa and Clinical and Coding Components for Basivertebral Nerve Ablation View Feb 01, 2023 CPT Code Changes for Spine Procedures View Dec 01, 2022 How to Avoid a Peer to Peer and When It May Be Helpful View Oct 01, 2022 2022 CPT Coding Changes For Spine Procedures View Dec 01, 2021 CMS Publishes Final Rules for 2022 Medicare Payments to Physicians Basivertebral nerve AND Basivertebral nerve ablation AND Discogenic pain AND Ablation AND Vertebrogenic back pain 3: Studies within the Last Five Years: Google Scholar: June 23, 2022: Basivertebral nerve ablation AND spinal nerve AND nonradiating AND discogenic pain AND vertebrogenic pain 29: Articles Published from 2010 - 2022 ablation of the basivertebral nerve (BVN). North American Spine Society Journal (NASSJ Established ICD-10-CM code for vertebrogenic low back pain (M54. The authors and the publishers do not accept responsibility or legal liability for any Intraosseous radiofrequency ablation of the basivertebral nerve (e. The thermal You are correct in that there are guidelines on how to code L5 dorsal ramus, S1, S2, S3 ablations and they instruct you to code 64640 with four units of service. 816) and Spondylosis without myelopathy or radiculopathy, lumbosacral region (M47. 2024 Reimbursement Guide for Physicians and Facilities. Perhaps someone else here with more experience in these procedures can CPT® Code 64628 in section: Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance. Pulsed RF is for pain management of should Since the 1950s, electrical currents have been used to create predictable thermal lesions; however, the use of radiofrequency for intractable pain did not appear in the literature until the 1970s. Each conduction study is counted as one for s ensory, Pulsed RFA is common for this nerve, but a thermal ablation would kill off the nerve supply to the supraspinatus and infraspinatus muscles causing wasting away. Policy Use this page to view details for the Local Coverage Determination for Intraosseous Basivertebral Nerve Ablation. Effective Date: July 1, 2024 Last Revised: June 10, 2024 . CPT 64629 refers to the thermal destruction of the intraosseous basivertebral nerve, a procedure aimed at alleviating chronic lower back pain by targeting specific nerves within the vertebrae. 2017;17(2):218-223. Two lesions in this area are recommended to maximize the ablation zone. Local Injections for Cervicogenic Headache and Occipital Neuralgia . , Intracept ® Intraosseous Nerve Ablation System. CMS is also proposing new RVUs for basivertebral nerve ablation. gov Web site currently does not fully support browsers with "JavaScript" disabled. The CMS. Examples If both facet joints at the same vertebral level are treated, then the parent code (64633 or 64635) should be reported with modifier 50 appended. of intraosseous radiofrequency nerve ablation of the basivertebral nerve (e. LCD: Intraosseous Basivertebral Nerve Ablation (L39644) IMPORTANT NOTICE: While some services or items may appear medically indicated for an individual, According to the local coverage article (LCA) A58405, CPT codes 64492 and 64495, as well as Category III codes 0213T-0218T, are all non-covered services for Medicare; however, CPT codes Upon further consideration, the ICD-10 codes for Spondylosis without myelopathy or radiculopathy, lumbar region (M47. lesioning/ablation can be reported with CPT 64640. N Am Spine Soc J. The Oswestry Disability Index (ODI), Visual Analog Scale (VAS), and SF-36 were recorded in Medrio electronic data CPT 64625 describes radiofrequency ablation of nerves innervating the sacroiliac joint, with image guidance such as fluoroscopy or computed tomography. (AMA) has added Current Procedural Terminology two category I codes for basivertebral nerve ablation: 64628 and 64629. 6/2023 Annual policy review. HCPCS Basivertebral Nerve Ablation Policy # 00077 Original Effective Date: 11/21/2001 Current Effective Date: 09/01/2024 FDA product code: GXI. , CPT codes 64633, 64634, 64635, and 64636 only apply to thermal (non-pulsed) radiofrequency ablation CPT code 64999 is to be used for pulsed radiofrequency ablation Jan 28, 2024 · The International Society for the Advancement of Spine Surgery (ISASS) 2020 guideline – Intraosseous Ablation of the Basivertebral Nerve for the Relief of Chronic Low Back Pain concluded that “The procedure is supported by level 1 evidence including 2 RCTs demonstrating a statistically significant decrease in pain and an improvement in 3 days ago · Established ICD-10-CM code for vertebrogenic low back pain (M54. CPT codes, descriptions and materials are copyrighted by the American Medical Association (AMA). 817) will be added to the Billing and Coding article: Thermal Destruction of the Intraosseous Basivertebral Nerve (BVN) for Vertebrogenic Lower Basivertebral nerve ablations were performed on 16 consecutive patients by a single surgeon (WS) utilizing the INTRACEPT® device (Relievant Medsystems, Inc. A small incision was made and under fluoroscopic guidance the introducer trocar is inserted percutaneously into the pedicle and the L5 vertebral body. There are no applicable HCPCS codes. there are quite a few changes to the heart ablation codes with a grand new radiofrequency nerve ablation of the basivertebral nerve (e. , tarsal tunnel syndrome, sciatica) peripheral neuropathy . Roufaiel That brings the total number of CPT codes to 10,819 per the AMA. S The Intracept Procedure Intraosseous Nerve Ablation System is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 vertebrae for the relief of chronic low In terms of the CPT code used for billing, third occipital nerve radiofrequency ablation is typically coded as 64493 (Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves Intraosseous Basivertebral Nerve Ablation . Refer to the Local Coverage Determination (LCD) L39642 Intraosseous Basivertebral Ablation, for reasonable and necessary requirements and frequency limitations. 6, 10 Although vertebral endplate changes are a radiological finding characterized by Relievant Medsystems announced that new Category I Current Procedural Terminology (CPT) codes for the Intracept Intraosseous Nerve Ablation procedure, used in the treatment of chronic lower back pain, are in effect as of January 1, 2022. Greater occipital nerve blocks have been advocated as a diagnostic test for cervicogenic Use this page to view details for the Local Coverage Determination for Intraosseous Basivertebral Nerve Ablation. Modic changes represent an intraosseous source of pain similar to tumors, stress fractures, etc. This procedure is performed under imaging guidance, allowing the healthcare provider to accurately navigate to the nerve and apply thermal energy to destroy it. ISASS was heavily involved in the creation of these new Dec 10, 2019 · CPT Code Description; 22899: Unlisted procedure, spine: Typical ICD-10 diagnosis codes that indicate medical necessity are: ICD-10 Franke J, et al. Use of these CPT codes for any other indication or Radiofrequency ablation of the intraosseous basivertebral nerve for the treatment of vertebrogenic back pain is considered experimental, investigational, or unproven (EIU). 15,16 The BVN exits the vertebral body posteriorly via the basivertebral foramen before communicating with the sinuvertebral nerve then the ventral rami of the spinal nerves or by nerves derived from the gray rami communicantes 16 When the The index 2020 ISASS Guideline Statement "Intraosseous Ablation of the Basivertebral Nerve for the Relief of Chronic Low Back Pain" was generated in response to growing requests for background, supporting literature, evidence, as well as proper coding for intraosseous basivertebral nerve ablation. 0000000000001622 Corpus ID: 270224696; Basivertebral Nerve Radiofrequency Ablation (Intracept): Procedural Technique. 44. There is also convincing evidence that BVN ablation is more beneficial than current standard of care for the treatment of chronic LBP. CPT 64635 64636 are for destruction by radiofrequency of the facet joint nerves that innervate the facet joints. (You may have to accept the AMA Apr 11, 2020 · Intraosseous radiofrequency ablation of the basivertebral nerve (e. General Background Nerves transmit electrochemical impulses between the central nervous system and muscles and organs within the body. Aug 21, 2024 · The Intracept Intraosseous Nerve Ablation System is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 vertebrae for the relief of chronic low back pain CPT 64628 refers to the thermal destruction of the intraosseous basivertebral nerve, a procedure aimed at alleviating chronic lower back pain by targeting specific nerves within the lumbar or Dec 27, 2024 · The Intracept procedure is a treatment option to treat vertebrogenic pain. d Peripheral Nerves Procedure (CPT ®) Codes (CMM-208) This guideline relates to the CPT CPT 64629 refers to the thermal destruction of the intraosseous basivertebral nerve, a procedure aimed at alleviating chronic lower back pain by targeting specific nerves within the vertebrae. There was a regression analysis performed by doctor, Dr. ICD-10-CM; DRGs; HCCs; CDPS, CDPS+Rx, MRX; ICD-11; SNOMED CT; ICD-9-CM; procedures. Description, summary, and references updated. For clinical The Intracept procedure, which is a basivertebral nerve ablation, is a minimally invasive procedure that helps reduce pain symptoms for chronic low back pain sufferers. Reimbursement Documents and Forms. g. KEY Designates an existing CPT code with new revisions in 2022 Designates a new CPT code in 2022 + Designates an add-on code that must be reported with the appropriate base code Basivertebral Nerve Ablation. (You may have to accept the AMA License Agreement. Intraosseous Radiofrequency Nerve Ablation of the Basivertebral Nerve . ) is used to perform Jul 30, 2024 · When billing Medicare for the Intracept Procedure performed in a facility setting, the following CPT codes and payment details are used: CPT 64628: Thermal destruction of intraosseous basivertebral nerve, including all Aug 21, 2024 · The Intracept Intraosseous Nerve Ablation System is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the Apr 11, 2020 · CPT code 64999 is to be used for pulsed radiofrequency ablation (CPT® Assistant, 2016) CPT Code Description 22899 Unlisted procedure, spine [when used to report the Jan 3, 2022 · It involves a minimally invasive procedure that targets the basivertebral nerve with radiofrequency-based ablation. Know the CPT Codes: The Current Procedural Terminology (CPT) codes that are commonly used for radiofrequency ablation of the lumbar region are 64635 (Radiofrequency ablation, lumbar or sacral, denervation of the facet joint Figure of Coronal Mid Pedicle Cut of Lumbar Spine. Ablation of the basivertebral nerve for treatment of back pain: a clinical study. FDA has cleared Relievant’s Intracept System for the following Indications for Use: The Intracept Intraosseous Nerve Ablation System is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 vertebrae for the relief of chronic low back pain of at least 6 months duration that has not Intracept System (intra-osseous basivertebral nerve ablation) for the treatment of low back pain, (List separately in addition to code for primary procedure) [not covered for cooled radiofrequency ablation] CPT codes not covered for indications listed in the CPB: 64625: Radiofrequency ablation, nerves innervating the sacroiliac joint, The degenerated vertebral body endplates are innervated by the basivertebral nerve, which sends pain signals to the brain. The code specifically On the Medicare Coverage Database (MCD) you can use CPT/HCPCS codes to search for documents. , Intracept ® System) (CPT Codes 64628 and 64629) (new to policy) Added language to indicate: o Medicare does not have a National Coverage Determination (NCD) for thermal destruction of intraosseous basivertebral nerve DOI: 10. Surgical Technique. 2 Lorio et al concluded that BVNA was a new single arm study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 12-month results. Coding Guidance: Providers should refer to the applicable AMA CPT Manual to assist with proper reporting of these services. Updated ISASS Policy Guideline for Interosseous Basivertebral Nerve Ablation. The Intracept Intraosseous Nerve Ablation System “is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 Use of these CPT codes for any other indication or Radiofrequency ablation of the intraosseous basivertebral nerve for the treatment of vertebrogenic back pain is considered experimental, investigational, or unproven (EIU). 0. When To Use CPT 64628. Additionally, the AMA has recognized a need for greater specificity in differentiating various types of low back pain and has designated the What is the CPT code for ilioinguinal nerve radiofrequency ablation? When it comes to treating chronic pain conditions, radiofrequency ablation (RFA) has become a popular and effective technique. Becker et al. [] conducted the earliest known BVN ablation clinical study to demonstrate the efficacy of BVN ablation in the treatment of chronic lumbar back pain. Radiofrequency ablation of the intraosseous basivertebral nerve for the treatment of vertebrogenic back pain is considered experimental, investigational, or unproven (EIU). Learn how AI and automation can help with medical coding accuracy. 2020;3:100030. Use this page to view details for the Local Coverage Determination for Intraosseous Basivertebral Nerve Ablation. (CPT Coding Guidance: Providers should refer to the applicable AMA CPT Manual to assist with proper reporting of these services. 2022 Sep 14:15:2801-2819. Purpose: The purpose of this study was to determine the efficacy of intraosseous basivertebral nerve (BVN) ablation for the treatment of chronic lumbar Relievant Medsystems, a company transforming chronic low back pain (CLBP) treatment, announced new Category I Current Procedural Terminology (CPT) codes for the Intracept Procedure are in effect as of January 1, 2022. 135 Meadowlands Pkwy, Secaucus, NJ 07094 (Radiofrequency ablation, lumbar or sacral, denervation of the facet joint nerves) and 64636 (Radiofrequency ablation Intracept System (intra-osseous basivertebral nerve ablation) for the treatment of low back pain, and neck pain; (List separately in addition to code for primary procedure) [not covered for cooled radiofrequency ablation] CPT codes not covered for indications listed in the CPB: 64625: Radiofrequency ablation, nerves innervating the The basivertebral nerve ablation, or Intracept procedure, is an outpatient, minimally invasive procedure in which the vertebral body is accessed utilizing fluoroscopic (x-ray) guidance through a small skin incision. JE Part A And this is the reason, the CDC added the diagnosis code vertebrogenic low back pain to the code set in 2021. 13 Contraindications include pregnancy, skeletal immaturity, active local or Multiple LCDs: Intraosseous Basivertebral Nerve Ablation and Trigger Point Injections (TPI) Open Public Meeting - August 31, 2023 - JE Part A. Therefore, the new codes indicate "nerve(s)" in the descriptors. CPT and HCPCS Codes Policy Number: 221 BCBSA Reference Number: N/A Effective Date: April 1, 2023 Related Policies Musculoskeletal Services Management, #220 Intraosseous Basivertebral Nerve Ablation, #482 Sacral Nerve Neuromodulation-Stimulation, #153 Overview Positioning the active tip of the RF needle more laterally and superiorly on the head of the humerus will avoid motor recruitment. Long-term outcomes following intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm This minimally invasive procedure targets the basivertebral nerve (BVN) within the vertebral body to alleviate pain. Evaluations were performed at baseline, 1 month, 3 months, and 6 months. The International Society for the Advancement of Spine Surgery (ISASS) 2020 guideline – Intraosseous Ablation of the Basivertebral Nerve for the Relief of Chronic Low Back Pain concluded that “The procedure is supported by level 1 evidence including 2 RCTs demonstrating a statistically significant decrease in pain and an improvement in The International Society for the Advancement of Spine Surgery (ISASS) 2020 guideline – Intraosseous Ablation of the Basivertebral Nerve for the Relief of Chronic Low Back Pain concluded that “The procedure is supported by level 1 evidence including 2 RCTs demonstrating a statistically significant decrease in pain and an improvement in Basivertebral Nerve Ablation • Intracept® Intraosseous Nerve Ablation System **To verify authorization requirements for a specific code by plan type, please use the Pre-authorization Code Check. It is important to consult with the insurance company or Medicare to The Intracept Intraosseous Nerve Ablation System “is intended to be used in conjunction with radiofrequency (RF) generators for the ablation of basivertebral nerves of the L3 through S1 vertebrae for the relief of chronic low back pain of at least six months duration that has not responded to at least six months of conservative care”. 64600 Destruction by neurolytic agent, trigeminal nerve; supraorbital, intraorbital, mental, or interior alveolar branch 2019 New CPT Codes Medicare Payments For Virtual Services Remote Monitoring Interprofessional Consultation 2025 RCM Trends Chronic-care-management-in This article describes coding changes for endovascular and interventional proce-dures that took effect on January 1, 2022. Replaces: 7. 1, 2022 — include Dec 10, 2019 · This ISASS guideline is generated to respond to growing requests for background, supporting literature and evidence, and proper coding for intraosseous ablation of the Basivertebral nerve (BVN) for chronic low back Jan 2, 2025 · The following codes are included below for informational purposes only; this is not an all-inclusive list. " As of January 2022, two current procedural terminology (CPT) codes . This treatment uses radiofrequency energy to interrupt nerves from carrying pain signals from damaged discs in the spine to the brain. Basivertebral nerve ablation for the treatment of chronic low back pain in a community practice setting: 6 Months follow-up. 4. The index 2020 ISASS Guideline Statement “Intraosseous Ablation of the Basivertebral Nerve for the Relief of Chronic Low Back Pain” was generated in response to growing requests for background, supporting literature, evidence, as well as proper coding for intraosseous basivertebral nerve ablation. The page could not be loaded. Patient with lumbosacral degenerative disc disease presents for basivertebral nerve ablation. This article explores real-world scenarios to understand how AI and automation can help with medical coding accuracy. First part is to (1) Use of these CPT codes for any other indicationor condition is not in scope for this guideline. Long-term outcomes following intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm Table 1: CPT/HCPCS Codes Code Description 64628 Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first two 1. Radiofrequency denervation/ablation of the nerves innervating the sacroiliac joint for the treatment of sacroiliac (SI Basivertebral nerve (BVN) ablation is a minimally invasive spinal procedure targeting the BVN, which is responsible for carrying nociceptive information from damaged vertebral endplates, an entity recently postulated as a source of chronic axial low back pain (LBP). ). Please refer to the member’s contract benefits in effect at the time of service to determine basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm results Coding Guidance: Providers should refer to the applicable AMA CPT Manual to assist with proper reporting of these services. , Basivertebral Nerve Ablation A59466 Billing and Coding: Intraosseous Basivertebral Nerve Ablation Part A and B MAC Noridian N/A L39644 Intraosseous Basivertebral Nerve CPT Codes / HCPCS Codes / ICD Codes Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. 01. Clinical Rationale Radiofrequency ablation of intraosseous nerves is an emerging technology intended for treatment of ablation of basivertebral nerves of the L3 through S1 vertebrae; for the relief of chronic low CPT/HCPCS Level II Codes (Note: The inclusion of a code in this list is not a guarantee of coverage. 64629 Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each Jul 9, 2024 · Basivertebral Nerve Ablation Policy Number: 076 Commercial and Qualified Health Plans MassHealth Medicare Advantage Authorization Required X X No Prior Authorization Authorized CPT/HCPCS Codes Code Description 64628 Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first two vertebral bodies, lumbar or Fischgrund JS, Rhyne A, Franke J, et al. Intraosseous Basivertebral Nerve Ablation Procedure CPT/HCPCS codes covered by Utah State Medicaid may still require further evaluation to determine medical necessity for coverage. Enter the CPT/HCPCS code in the MCD Search and select your state from the drop down. ) Established codes: The following facet joint nerve ablation techniques are unproven and not medically necessary due to insufficient Intraosseous radiofrequency ablation of the basivertebral nerve (e. This intraosseous source of pain is secondary to degenerative processes of the spine confirmed by end plate changes best detected using MRI Sayed, Dawood, and others, 'Basivertebral Nerve Ablation', in Dawood Sayed, and others (eds), the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The basivertebral nerve ablation, or Intracept procedure, is an outpatient, minimally invasive procedure in which the vertebral body is accessed utilizing fluoroscopic (x-ray) guidance through a small skin incision. Further reproducible large clinical studies are needed to study BVN ablation before clinicians can confidently apply this treatment in their practice. The International Society for the Advancement of Spine Surgery (ISASS) 2020 guideline – Intraosseous Ablation of the Basivertebral Nerve for the Relief of Chronic Low Back Pain concluded that “The procedure is supported by level 1 evidence including 2 RCTs demonstrating a statistically significant decrease in pain and an improvement in Coding Guidance: Providers should refer to the applicable AMA CPT Manual to assist with proper reporting of these services. Jul 17, 2024 · CMM-208: Ablations/Denervations of Facet Joints and Peripheral Nerves Definitions General Guidelines Indications Non-Indications Procedure (CPT ®) Codes (CMM-208) References (CMM-208) Comprehensive Musculoskeletal Management Guidelines V. Check your VII. (CPT) codes have been established to report the BVNA procedure, 64,628 (first two vertebral bodies) and 64,629 (each additional vertebral body). CPT code 64999 is to be used for pulsed radiofrequency ablation. As of January 1, 2022, two Category I Current Procedural Terminology (CPT) codes, 64628 and 64629, are in effect for the Intracept Procedure. Peripheral Nerve Destruction Peripheral nerve destruction using cryoablation or Basivertebral nerve ablation is targeted to treat lower back pain consistent with Modic changes (MC). CPT Code 64628. Results will return Billing and Coding Articles or other documents that include the specified code. ISASS will review the final rule in detail and provide written comments to CMS to all relevant issues in advance of the comment deadline. Policy: 7. The Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code(s) may be subject to National Correct Coding Initiative (NCCI) edits. Basivertebral nerve density has been found to be higher in endplate regions that have been damaged, indicating a connection between these nerves and CLBP. In all 3 types of endoscopic surgeries, the procedure consists of 2 parts. ISASS was heavily involved in the creation of these new code descriptors and believes both sets will allow more accurate billing and reimbursement for spine surgical procedures. The basic premise involves the passage of radiofrequency currents through an electrode placed near a nociceptive pathway to interrupt the pain impulses. codes diagnosis. All related ICD-10 diagnoses codes apply. CPT code 64628 is used when performing thermal destruction of the basivertebral nerve in the lumbar or sacral region, specifically for the first two vertebral bodies during a single session. 13 Contraindications include pregnancy, skeletal immaturity, active local or These codes include CPT code 64450 for a bilateral injection into the femoral nerve and CPT code 64455 for a unilateral injection into the obturator nerve. 1097/BSD. The new CPT codes — which went into effect as of Jan. Current Reports and Studies. HCPCS Trigger point injection(s) of anesthetic and/or corticosteroid (CPT codes 20552, 20553) for the diagnosis/stabilization of subacute or chronic back pain, neck pain, or myofascial pain syndrome is considered medically necessary when pain has persisted despite appropriate conservative treatment, including pharmacological therapy, physical As of January 1, 2022, two Category I Current Procedural Terminology (CPT) codes, 64628 and 64629, are in effect for the Intracept Procedure. Skeletal maturity radiofrequency ablation (CPT 64625) are not covered body, lumbar or sacral (List separately in addition to code for primary procedure) (Commercial and Medicare Only) 64633 Destruction by Coding Guidance: Providers should refer to the applicable AMA CPT Manual to assist with proper reporting of these services. Background content: Lumbar axial back pain arising from degenerative disc disease continues to be a challenging clinical problem whether treated with nonsurgical management, local injection, or motion segment stabilization and fusion. e. , Intracept CPT code 64999 is to be used for pulsed radiofrequency ablation (CPT 64628 Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral Jan 28, 2024 · The International Society for the Advancement of Spine Surgery (ISASS) 2020 guideline – Intraosseous Ablation of the Basivertebral Nerve for the Relief of Chronic Low Back Pain concluded that “The procedure is supported by level 1 evidence including 2 RCTs demonstrating a statistically significant decrease in pain and an improvement in Dec 27, 2024 · Codes The following code(s) require prior authorization: Table 1: CPT/HCPCS Codes Code Description 64628 Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first two vertebral bodies, lumbar or sacral. , Intracept®)" As of 1/2019, the Intracept Manufacturer says to use the unlisted code, here. Listing of a service code in this policy does not imply that the service described by this code is a covered or non-covered healthservice. Background Your Billing Codes for the Peripheral Nerve Ablation are listed below. vrh nuobwvi aooou uplx ovulx vflxfw xnucfqk ajus pzc mok