Report CPT code 64633 if a provider destroyed a facet joint nerve in the thoracic or cervical spinal segments with neurolytic agents.
1. What Is CPT Code 64633?
CPT 64633 covers a procedure in which a surgeon destroys a facet joint nerve of the patient’s thoracic or cervical spinal segments with neurolytic agents, such as;
- a chemical compound;
- electric current; or
This procedure is performed with a CT scan or fluoroscopy for imaging guidance, and injected on a single-facet joint.
The CPT book defines the 64633 CPT code as follows: “Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint.”
The goal of this procedure is to treat a patient with spinal pain. The surgeon begins the CPT 64633 procedure by inserting a needle through the patient’s skin after they have been anesthetized and prepped.
Then, they move the needle until it is in the correct position with the thoracic or cervical joint, which connects two vertebrae.
The provider uses fluoroscopy or a CT scan for imaging guidance. They then identify the nerve that needs to be destroyed. They can use several or a single technique for destroying the nerve root, such as;
- electric; or
The Radiofrequency Method: This technique is called rhizotomy and uses radiowaves for heating and an electrode placed on the nerve root, thereby destroying it.
The Chemical Method: This technique destroys the nerve root chemically with a substance such as alcohol.
The Electric Method: Electric current is used to burn the nerve root.
The Thermal Method: The thermal technique uses heat to burn the nerve root.
Finally, they remove the needle before ensuring that the site obtains hemostasis.
4. How To Use CPT 64633
Use CPT code 64633 only if the provider performed the injection on a single facet joint. Report this code per joint and not per nerve.
CPT 64633 is a unilateral service but can be billed bilaterally if you append modifier 50 to the claim.
Imaging guidance with a CT scan or fluoroscopy is included in the 64633 code and can not be billed separately.
Report CPT 64999 instead of CPT 64633 if a surgeon provided the same procedure without imaging guidance.