In simple words: This procedure uses imaging to guide a needle to the nerves around a joint in your lower back. Medicine is injected to destroy these nerves to relieve pain.

This code describes the destruction of paravertebral facet joint nerves in the lumbar or sacral region using a neurolytic agent under imaging guidance (fluoroscopy or CT). This procedure targets a single facet joint.

Example 1: A patient with chronic lower back pain localized to a single facet joint in the lumbar region undergoes destruction by neurolytic agent with CT guidance. Code: 64635., A patient experiences pain at two facet joints on the left side of the lumbar spine. Two units of 64635 are reported. Code: 64635 x 2., The physician treats four facet joints – two on each side of the lumbar area bilaterally. Modifier 50 is appended to 64635 for each side. Code: 64635-50 x 2

Documentation should include details of the patient's pain, diagnostic imaging confirming the affected facet joint, the type of neurolytic agent used, imaging guidance used (fluoroscopy or CT), and any other interventions performed during the procedure.