How To Use CPT Code 64517

CPT 64517 describes the injection of an anesthetic agent into the superior hypogastric plexus, which is part of the autonomic nervous system. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64517?

CPT 64517 can be used to describe the injection of an anesthetic agent into the superior hypogastric plexus. This procedure is performed to treat chronic pelvic pain that is nonresponsive to medications. The superior hypogastric plexus is a bundle of nerves that innervates the lower pelvic organs and genitalia. By blocking this nerve bundle, the provider can effectively alleviate the patient’s pain.

2. Official Description

The official description of CPT code 64517 is: ‘Injection, anesthetic agent; superior hypogastric plexus.’

3. Procedure

1. The provider prepares the patient and uses imaging guidance, such as fluoroscopy, to locate the superior hypogastric plexus.
2. Using two needles, the provider carefully inserts them through the skin and tissue into the prevertebral space, anterior to the L5/S1 vertebral junction.
3. Contrast may be used to verify the correct needle placement and ensure that the medication will spread in the appropriate area.
4. Once needle placement is confirmed, the provider injects a local anesthetic into both sides of the superior hypogastric plexus.

4. Qualifying circumstances

CPT 64517 is performed on patients with chronic pelvic pain that is nonresponsive to medications. The procedure targets the superior hypogastric plexus, which is responsible for innervating the lower pelvic organs and genitalia. It is important to note that this procedure does not include fluoroscopic guidance, so it should be reported separately if performed.

5. When to use CPT code 64517

CPT code 64517 should be used when the provider performs an injection of an anesthetic agent into the superior hypogastric plexus to treat chronic pelvic pain. It is important to ensure that the pain is nonresponsive to medications before proceeding with this procedure.

6. Documentation requirements

To support a claim for CPT 64517, the provider must document the following information:

• Patient’s diagnosis of chronic pelvic pain
• Confirmation that the pain is nonresponsive to medications
• Date of the procedure
• Details of the procedure, including the use of imaging guidance and the injection of the anesthetic agent
• Verification of correct needle placement and absence of complications
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 64517, it is important to note that fluoroscopic guidance is not included in this code. Therefore, if fluoroscopy is used during the procedure, it should be reported separately. It is also important to ensure that the documentation supports the medical necessity of the procedure and the nonresponsiveness of the patient’s pain to medications.

8. Historical information

CPT 64517 was added to the Current Procedural Terminology system on January 1, 2004. There have been no updates to the code since its addition.

9. Examples

1. A patient with chronic pelvic pain undergoes an injection of an anesthetic agent into the superior hypogastric plexus to alleviate their symptoms.
2. A provider performs CPT 64517 on a patient with chronic pelvic pain that is nonresponsive to medications, targeting the superior hypogastric plexus to provide pain relief.
3. Using CPT 64517, a provider administers an anesthetic agent into the superior hypogastric plexus of a patient with chronic pelvic pain, aiming to alleviate their symptoms.
4. A patient with chronic pelvic pain receives an injection of an anesthetic agent into the superior hypogastric plexus, performed using CPT code 64517.
5. During a procedure, a provider injects an anesthetic agent into the superior hypogastric plexus of a patient with chronic pelvic pain, utilizing CPT 64517.
6. Using CPT code 64517, a provider performs an injection of an anesthetic agent into the superior hypogastric plexus to treat chronic pelvic pain in a patient.
7. A patient with chronic pelvic pain undergoes CPT 64517, which involves the injection of an anesthetic agent into the superior hypogastric plexus to alleviate their symptoms.
8. During a procedure, a provider administers an anesthetic agent into the superior hypogastric plexus of a patient with chronic pelvic pain, utilizing CPT code 64517.
9. Using CPT 64517, a provider performs an injection of an anesthetic agent into the superior hypogastric plexus to alleviate chronic pelvic pain in a patient.
10. A patient with chronic pelvic pain receives CPT 64517, which involves the injection of an anesthetic agent into the superior hypogastric plexus to provide pain relief.