How To Use CPT Code 64629

CPT 64629 describes the thermal destruction of intraosseous basivertebral nerves using a heat method under imaging guidance. 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 64629?

CPT 64629 can be used to describe the thermal destruction of intraosseous basivertebral nerves using a heat method under imaging guidance. This code is used for each additional lumbar or sacral vertebral body treated after the first two at a session.

2. Official Description

The official description of CPT code 64629 is: ‘Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 64628 and should not be reported with CPT codes 77003 or 77012.

3. Procedure

1. After the thermal intraosseous basivertebral nerve destruction of the first two vertebral bodies at the session, the provider performs the procedure on an additional lumbar or sacral vertebral body.
2. The provider uses imaging guidance to assist with inserting a specialized cannula and guiding it through the vertebral pedicle.
3. A heating tool, such as a radiofrequency probe, is placed into the path to reach the basivertebral nerve.
4. The provider uses the tool to ablate (destroy) the basivertebral nerve of the vertebral endplate.
5. This procedure is performed on each additional lumbar or sacral vertebral body after the first two treated at a session.

4. Qualifying circumstances

This procedure is performed on patients with chronic lower back pain caused by damaged vertebral endplates. The basivertebral nerve density may be higher in these areas, and ablating these nerves can help alleviate the pain. The procedure is performed by a provider using a heat method under imaging guidance.

5. When to use CPT code 64629

CPT code 64629 should be used when the provider performs the thermal destruction of intraosseous basivertebral nerves on each additional lumbar or sacral vertebral body after the first two at a session. It should not be reported as a standalone code and should be used in conjunction with CPT code 64628.

6. Documentation requirements

To support a claim for CPT code 64629, the provider must document the following information:

• Number of additional lumbar or sacral vertebral bodies treated
• Imaging guidance used during the procedure
• Specific details of the thermal destruction technique
• Start and end time of the procedure
• Any complications or adverse events
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 64629, ensure that the procedure is performed on each additional lumbar or sacral vertebral body after the first two at a session. Report it in conjunction with CPT code 64628. Do not report it with CPT codes 77003 or 77012. It is important to include the appropriate primary code to receive reimbursement for this add-on code.

8. Historical information

CPT code 64629 was added to the Current Procedural Terminology system on January 1, 2022. There have been no updates to the code since its addition.

9. Examples

1. A provider performs the thermal destruction of intraosseous basivertebral nerves on the third lumbar vertebral body during a session.
2. After treating the first two lumbar vertebral bodies, the provider uses a heat method under imaging guidance to destroy the basivertebral nerves on the fourth and fifth lumbar vertebral bodies.
3. During a session, the provider performs the thermal destruction of intraosseous basivertebral nerves on the second and third sacral vertebral bodies.
4. After treating the first two sacral vertebral bodies, the provider uses a heat method under imaging guidance to destroy the basivertebral nerves on the fourth sacral vertebral body.
5. A patient undergoes the thermal destruction of intraosseous basivertebral nerves on the second and third lumbar vertebral bodies at a session.
6. During a session, the provider performs the procedure on the fourth and fifth sacral vertebral bodies using a heat method under imaging guidance.
7. After treating the first two lumbar vertebral bodies, the provider uses a radiofrequency probe to destroy the basivertebral nerves on the third lumbar vertebral body.
8. A patient receives the thermal destruction of intraosseous basivertebral nerves on the fourth and fifth sacral vertebral bodies during a session.
9. During a session, the provider performs the procedure on the second and third lumbar vertebral bodies using a heat method under imaging guidance.
10. After treating the first two sacral vertebral bodies, the provider uses a specialized cannula to destroy the basivertebral nerves on the third sacral vertebral body.