2025 CPT code 64610
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Feed
Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring.
Modifiers applicable: 22, 47, 50, 51, 52, 54, 55, 56, 58, 73, 74, 76, 77, 78, 79, 99, AQ, AR, CR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6 QJ, RT.
Medical necessity for this procedure must be established through documentation of the patient's condition (e.g., trigeminal neuralgia, other neuropathic facial pain) and failed attempts at conservative management (e.g., medication, physical therapy). Documentation should also confirm the anatomical location targeted and the specific clinical rationale for performing the procedure.
In simple words: This procedure helps relieve severe facial pain caused by trigeminal neuralgia. The doctor uses imaging guidance to precisely target a specific area of the trigeminal nerve and injects a substance that disrupts the nerve's ability to send pain signals. This can provide significant pain relief.
This code represents a procedure where a physician destroys parts of the trigeminal nerve using a neurolytic agent (e.g., chemical, thermal, electrical, or radiofrequency) at the foramen ovale under radiologic monitoring (e.g. fluoroscopy or CT guidance). This procedure is typically performed to treat trigeminal neuralgia, a chronic pain condition affecting the face.
Example 1: A patient with intractable trigeminal neuralgia, unresponsive to medication, undergoes percutaneous radiofrequency ablation of the trigeminal ganglion at the foramen ovale under fluoroscopic guidance., A patient with trigeminal neuralgia secondary to multiple sclerosis undergoes glycerol rhizotomy of the trigeminal ganglion at the foramen ovale under CT guidance., A patient with cluster headaches, not responding to other treatments, undergoes percutaneous balloon compression of the trigeminal ganglion at the foramen ovale under fluoroscopic guidance.
Documentation should include details of the patient's diagnosis, prior treatments, informed consent, the type of neurolytic agent used, the method of radiologic monitoring (e.g. fluoroscopy or CT), the nerves targeted, and the outcome of the procedure. Any complications encountered should also be documented.
- Specialties:Neurosurgery, Pain Management, Anesthesiology
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient, Office