How To Use CPT Code 64633

CPT 64633 describes the destruction of the paravertebral facet joint nerve(s) using a neurolytic agent, with the guidance of imaging such as fluoroscopy or CT scan. 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 64633?

CPT 64633 is a code used to describe the destruction of the paravertebral facet joint nerve(s) using a neurolytic agent. This procedure is performed by a healthcare provider and involves the use of imaging guidance, such as fluoroscopy or CT scan, to ensure accurate placement of the needle. The goal of this procedure is to treat spinal pain by destroying the affected nerve root.

2. Official Description

The official description of CPT code 64633 is: ‘Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring they are appropriately prepped and anesthetized.
2. The provider inserts a needle through the skin and advances it to the proper position within the cervical or thoracic facet joint, which is the joint connecting two spinal vertebrae together.
3. Using imaging guidance, such as fluoroscopy or CT scan, the provider identifies the exact nerve that needs to be destroyed.
4. The provider then uses a neurolytic agent, which can be heat, electric current, or a chemical compound, to destroy the affected nerve root.
5. The specific technique or combination of techniques used may include thermal, electric, chemical, or radiofrequency methods.
6. After the nerve root is destroyed, the provider removes the needle and ensures the site obtains hemostasis.
7. This procedure is performed on a single facet joint.

4. Qualifying circumstances

CPT 64633 is performed on patients who experience spinal pain and require the destruction of the paravertebral facet joint nerve(s). It is important to note that this code is used for a single facet joint, and only one code may be reported for each joint denervated, regardless of the number of nerves treated. The procedure must be performed by a qualified healthcare provider using imaging guidance, such as fluoroscopy or CT scan.

5. When to use CPT code 64633

CPT code 64633 should be used when a healthcare provider performs the destruction of the paravertebral facet joint nerve(s) using a neurolytic agent, with the guidance of imaging such as fluoroscopy or CT scan. It is important to report this code for each facet joint treated. If the procedure involves multiple facet joints at different vertebral levels in the same spinal region, additional codes such as 64634 or 64636 should be used.

6. Documentation requirements

To support a claim for CPT code 64633, the healthcare provider must document the following information:

• Patient’s diagnosis and indication for the procedure
• Specific details of the procedure, including the use of imaging guidance and the neurolytic agent used
• Date of the procedure
• Location of the facet joint treated
• Techniques used for nerve destruction
• Any complications or adverse events
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 64633, ensure that the procedure is performed by a qualified healthcare provider and that imaging guidance, such as fluoroscopy or CT scan, is used. It is important to report this code for each facet joint treated. Do not report imaging guidance separately. Additionally, be aware of any specific guidelines or modifiers that may apply when reporting this code.

8. Historical information

CPT code 64633 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs the destruction of the paravertebral facet joint nerve(s) in the cervical spine using a neurolytic agent, with the guidance of fluoroscopy.
2. Using CT scan guidance, a provider destroys the paravertebral facet joint nerve(s) in the thoracic spine of a patient experiencing spinal pain.
3. A qualified healthcare provider performs the destruction of the paravertebral facet joint nerve(s) in the cervical spine using a combination of thermal and chemical techniques, with the assistance of fluoroscopy.
4. With the guidance of CT scan, a provider destroys the paravertebral facet joint nerve(s) in the thoracic spine using radiofrequency ablation.
5. A healthcare provider performs the destruction of the paravertebral facet joint nerve(s) in the cervical spine using a neurolytic agent, with the assistance of fluoroscopy.
6. Using CT scan guidance, a provider destroys the paravertebral facet joint nerve(s) in the thoracic spine of a patient experiencing chronic spinal pain.
7. A qualified healthcare provider performs the destruction of the paravertebral facet joint nerve(s) in the cervical spine using a combination of thermal and chemical techniques, with the guidance of fluoroscopy.
8. With the assistance of CT scan, a provider destroys the paravertebral facet joint nerve(s) in the thoracic spine using radiofrequency ablation.