How To Use CPT Code 64624

CPT 64624 is a code used for the destruction of genicular nerve branches by a neurolytic agent, including imaging guidance when performed. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 64624 procedures.

1. What is CPT 64624?

CPT 64624 is a medical billing code used to describe the destruction of genicular nerve branches by a neurolytic agent, including imaging guidance when performed. This procedure is typically performed to treat knee pain caused by chronic osteoarthritis, degenerative joint disease, or knee pain after partial or total knee replacement surgery. It may also be used for patients who are not candidates for or do not want a knee replacement.

2. 64624 CPT code description

The official description of CPT code 64624 is: “Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed.”

3. Procedure

1. The patient is appropriately prepped, and the provider may inject the area around the proposed injection site with a local anesthetic.
2. Using fluoroscopic guidance, the provider selects the genicular nerve branches for neurolysis.
3. The provider may use a single technique or a combination of techniques, such as thermal, electric, chemical, and radiofrequency, to destroy the affected nerve branch.
4. In chemical destruction, the provider injects a chemical substance like alcohol or phenol.
5. In the radiofrequency method, the provider inserts a needle-like cannula that delivers radio waves to the nerve, thereby destroying it.
6. With electrical and thermal neurolysis, the provider uses an electrode to supply heat.
7. The provider treats the superolateral, superomedial, and/or inferomedial genicular nerve branches that supply the knee.
8. The provider removes the needle, cannula, or electrode and ensures hemostasis.
9. The provider withdraws the needle.

4. Qualifying circumstances

Patients eligible to receive CPT code 64624 services are those experiencing knee pain due to chronic osteoarthritis, degenerative joint disease, or knee pain after partial or total knee replacement surgery. Additionally, patients who are not candidates for or do not want a knee replacement may also qualify for this procedure.

5. When to use CPT code 64624

It is appropriate to bill the 64624 CPT code when the provider performs the destruction of genicular nerve branches by a neurolytic agent, including imaging guidance when performed, to treat knee pain caused by chronic osteoarthritis, degenerative joint disease, or knee pain after partial or total knee replacement surgery. It may also be used for patients who are not candidates for or do not want a knee replacement.

6. Documentation requirements

To support a claim for CPT 64624, the following information should be documented:

• Patient’s medical history and diagnosis related to knee pain
• Physical examination findings
• Consent for the procedure
• Details of the procedure, including the techniques used, nerve branches treated, and imaging guidance when performed
• Post-procedure care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 64624, it is important to follow the appropriate guidelines and rules. Do not report 64624 in conjunction with 64454. CPT 64624 requires the destruction of each of the following genicular nerve branches: superolateral, superomedial, and inferomedial. If a neurolytic agent for the purposes of destruction is not applied to all of these nerve branches, report 64624 with modifier 52.

8. Historical information

CPT 64624 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates since its addition.

9. Similar codes to CPT 64624

Five similar codes to CPT 64624 and how they differentiate are:

• CPT 64454: Injection of an anesthetic and/or steroid into the genicular nerves supplying the knee.
• CPT 64447: Injection of an anesthetic agent to the femoral nerve.
• CPT 64448: Continuous infusion of an anesthetic agent to the femoral nerve.
• CPT 64600 to 64647: Destruction by a neurolytic agent of other nerves.
• CPT 64622: Destruction by neurolytic agent, intercostal nerve.

10. Examples

Here are 10 detailed examples of CPT code 64624 procedures:

1. A 65-year-old patient with chronic osteoarthritis in the knee undergoes genicular nerve destruction using radiofrequency ablation.
2. A 55-year-old patient with degenerative joint disease in the knee receives chemical neurolysis of the genicular nerves.
3. A 70-year-old patient with persistent knee pain after total knee replacement surgery undergoes thermal neurolysis of the genicular nerves.
4. A 60-year-old patient who is not a candidate for knee replacement surgery receives electrical neurolysis of the genicular nerves for knee pain relief.
5. A 75-year-old patient with chronic knee pain due to osteoarthritis undergoes a combination of radiofrequency and chemical neurolysis of the genicular nerves.
6. A 50-year-old patient with knee pain after partial knee replacement surgery receives genicular nerve destruction using radiofrequency ablation.
7. A 68-year-old patient with degenerative joint disease in the knee undergoes chemical neurolysis of the genicular nerves with fluoroscopic guidance.
8. A 72-year-old patient with persistent knee pain after total knee replacement surgery receives thermal neurolysis of the genicular nerves using imaging guidance.
9. A 63-year-old patient who is not a candidate for knee replacement surgery undergoes electrical neurolysis of the genicular nerves with fluoroscopic guidance for knee pain relief.
10. A 78-year-old patient with chronic knee pain due to osteoarthritis receives a combination of radiofrequency and chemical neurolysis of the genicular nerves using imaging guidance.