How To Use CPT Code 64680

CPT 64680 describes the destruction of the celiac plexus using a neurolytic agent, with or without radiologic monitoring. 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 64680?

CPT 64680 is used to describe the destruction of the celiac plexus, a cluster of ganglia and radiating nerves in the abdomen, using a neurolytic agent. This procedure is performed to reduce the patient’s sensation of abdominal pain caused by conditions such as abdominal cancer, chronic pancreatic issues, or other severe chronic abdominal pain. The provider may use radiologic monitoring during the procedure, but this is not included in the code description.

2. Official Description

The official description of CPT code 64680 is: ‘Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus.’ This code specifically refers to the destruction of the celiac plexus using a neurolytic agent.

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. Using X-ray or CT guidance, the provider locates the anatomical structures and identifies the position of the celiac plexus.
3. A fine needle is inserted through the skin and tissue to the location of the plexus.
4. An aspiration test is performed to confirm the correct needle placement.
5. If the needle is appropriately positioned, a local anesthetic is injected at the site.
6. Following the local anesthetic injection, a neurolytic agent, such as alcohol, is injected to paralyze the nerves of the celiac plexus.
7. The procedure is typically performed on one side of the aorta, and then repeated on the other side to effectively reduce the patient’s feeling of pain.

4. Qualifying circumstances

CPT 64680 is performed for patients with severe chronic abdominal pain caused by conditions such as abdominal cancer, chronic pancreatic issues, or other abdominal conditions. The procedure targets the celiac plexus, a network of ganglia and nerves located in the upper abdomen. The provider must use a neurolytic agent to destroy the nerves of the plexus. Radiologic monitoring may be used during the procedure, but it is not included in the code description.

5. When to use CPT code 64680

CPT code 64680 should be used when the provider performs the destruction of the celiac plexus using a neurolytic agent. This code does not include radiologic monitoring, so if it is performed, it should be reported separately. It is important to ensure that the patient’s condition meets the qualifying circumstances for this procedure before using CPT code 64680.

6. Documentation requirements

To support a claim for CPT code 64680, the provider must document the following information:

• Patient’s diagnosis and the need for the destruction of the celiac plexus
• Confirmation of appropriate prepping and anesthesia
• Use of X-ray or CT guidance, if applicable
• Confirmation of correct needle placement through an aspiration test
• Injection of local anesthetic and neurolytic agent
• Procedure performed on one side of the aorta and repeated on the other side, if applicable
• Any additional procedures or services performed during the same encounter
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 64680, ensure that the destruction of the celiac plexus using a neurolytic agent is performed. If radiologic monitoring is also performed, it should be reported separately. It is important to follow the specific guidelines and requirements of the payer when submitting claims for this procedure. Additionally, it is recommended to report any additional procedures or services performed during the same encounter to accurately reflect the complexity of the case.

8. Historical information

CPT code 64680 was added to the Current Procedural Terminology system on January 1, 1990. The code description was updated on January 1, 2004 to include the option of radiologic monitoring. There have been no further updates or changes to the code since then.

9. Examples

1. A patient with abdominal cancer undergoes the destruction of the celiac plexus using a neurolytic agent to alleviate severe chronic abdominal pain.
2. A provider performs the destruction of the celiac plexus using a neurolytic agent for a patient with chronic pancreatic issues, aiming to reduce their abdominal pain.
3. A patient with severe chronic abdominal pain caused by an abdominal condition undergoes the destruction of the celiac plexus using a neurolytic agent to alleviate their symptoms.
4. A provider performs the destruction of the celiac plexus using a neurolytic agent for a patient with chronic abdominal pain, aiming to improve their quality of life.
5. A patient with severe chronic abdominal pain undergoes the destruction of the celiac plexus using a neurolytic agent to manage their symptoms and improve their overall well-being.
6. A provider performs the destruction of the celiac plexus using a neurolytic agent for a patient with abdominal cancer, aiming to alleviate their pain and improve their comfort.
7. A patient with chronic pancreatic issues undergoes the destruction of the celiac plexus using a neurolytic agent to reduce their abdominal pain and improve their daily functioning.