2025 CPT code 64600
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Feed
Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch.
Modifiers may be applicable.Modifier 22 (Increased Procedural Services) might be used if the service is significantly more complex than usual.Other modifiers, like 51 (Multiple Procedures), may be relevant depending on the specific circumstances.
Medical necessity for this procedure must be established.It is typically justified when conservative treatments for trigeminal neuralgia, such as medication, have failed to provide adequate pain relief or are not tolerated by the patient. In cases of facial spasm, it may be considered when other treatments have been ineffective.Detailed documentation of prior treatment failures and the severity of the patient's condition is crucial.
The physician prepares the patient and administers anesthesia. Then, a fine needle is inserted through the skin at a specific location to reach the targeted branch of the trigeminal nerve. Finally, the neurolytic agent is injected to destroy the targeted nerve fibers and disrupt pain signals or motor function.
In simple words: This procedure helps relieve severe facial pain caused by trigeminal neuralgia. The doctor injects medicine near the affected nerve to stop it from sending pain signals. It can also be used to reduce unwanted muscle movements in the face.
This code describes a procedure where a neurolytic agent is used to destroy parts of the trigeminal nerve.This nerve is responsible for sensation and some motor functions in the face. The procedure targets specific branches of the trigeminal nerve: supraorbital, infraorbital, mental, or inferior alveolar. It is commonly performed to alleviate chronic pain associated with trigeminal neuralgia (tic douloureux), or to impede motor function in the face or scalp.
Example 1: A patient experiences excruciating pain in their cheek and jaw due to trigeminal neuralgia. The physician performs a destruction of the inferior alveolar branch of the trigeminal nerve using a neurolytic agent (64600)., A patient with uncontrolled facial spasms undergoes destruction of the supraorbital branch of the trigeminal nerve (64600) to reduce the spasms., A patient suffering from persistent pain after shingles affecting the forehead has destruction of the supraorbital nerve with a neurolytic agent (64600).
Documentation should include details about the patient's condition (e.g., trigeminal neuralgia, facial spasm), the specific branch of the trigeminal nerve targeted (supraorbital, infraorbital, mental, or inferior alveolar), the type of neurolytic agent used, the approach used for injection, and any associated imaging guidance (if applicable). The medical necessity of the procedure should also be clearly documented, explaining why less invasive treatments were not suitable.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- Specialties:Neurosurgery, Pain Management, Neurology
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient, Office