2025 CPT code 64632
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System Surgical Procedures on the Nervous System Feed
Destruction of a plantar common digital nerve using a neurolytic agent (e.g., chemical, thermal, electrical, or radiofrequency).
Modifiers such as RT (right side) or LT (left side) may be used to indicate the specific nerve affected.Modifiers 51 (multiple procedures), 59 (distinct procedural service), and 76 (repeat procedure) may also be applicable depending on the specific circumstances.
Medical necessity for this procedure is established by documenting the presence of intractable neuropathic pain unresponsive to conservative management that significantly impairs the patient's quality of life.The procedure must be deemed the most appropriate treatment option after other therapies have been exhausted.
A physician specializing in podiatry or a surgeon specializing in peripheral nerve surgery would typically perform this procedure.The physician is responsible for pre-operative evaluation, procedural performance, post-operative care, and ensuring proper documentation.
- Surgical Procedures on the Nervous System
- Surgical Procedures on the Nervous System > Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System > Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) Procedures on the Somatic Nerves
In simple words: This code describes a procedure to destroy a nerve in the foot that's causing pain.The doctor uses a special substance, heat, electricity, or radio waves to do this. This is done to treat severe, ongoing nerve pain that hasn't gotten better with other treatments.
CPT code 64632 represents the destruction of a plantar common digital nerve using a neurolytic agent.The neurolytic agent may be chemical (e.g., alcohol with concentration >30%), thermal, electrical, or radiofrequency. This procedure is typically performed for the treatment of intractable neuropathic pain, often associated with conditions such as neuromas or mononeuritis.The procedure may involve fluoroscopic guidance, which is billed separately.The supply of the neurolytic agent is also billed separately if it is a chemodenervation agent. Do not report this code with 64455.
Example 1: A patient presents with intractable pain in the third plantar common digital nerve due to a neuroma that has not responded to conservative management.The podiatrist performs a neurolysis with >30% alcohol as the neurolytic agent under fluoroscopic guidance.This scenario would be coded with 64632 and appropriate modifiers., A patient with a history of diabetes and peripheral neuropathy experiences severe, chronic pain in the second plantar common digital nerve.After conservative measures fail, a surgeon performs a neurolytic procedure using radiofrequency ablation to destroy the affected nerve.This scenario would be coded with 64632., A patient has a persistent painful neuroma of the plantar common digital nerve post-surgical trauma.After conservative measures fail, a podiatrist performs a chemical neurolysis using a neurolytic agent with a concentration over 30% under local anesthesia. Code 64632 would be used.
* Detailed history and physical examination documenting the intractable neuropathic pain.* Documentation of failed conservative management (e.g., physical therapy, medication).* Preoperative imaging (if performed).* Operative report detailing the technique used, neurolytic agent used, and amount administered.* Postoperative pain assessment and plan of care.* Documentation of the concentration of alcohol if applicable.
** Payers may have specific requirements for reimbursement, including pre-authorization or documentation of the concentration of the neurolytic agent.Always consult payer guidelines before submitting claims.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- RVU: This information is not readily available in the provided sources.Consult the AMA CPT codes for RVU information.
- Global Days : This information is not provided in the source.Further research is needed to determine the global surgical period.
- Payment Status: Active, but payment may vary depending on payer and may require additional documentation or pre-authorization.
- Modifier TC rule: This information is not provided in the source.
- Fee Schedule : The provided data does not include historical fee schedules.Refer to payer-specific fee schedules for historical information.
- Specialties:Podiatry, Neurosurgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center