2025 CPT code 64624
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Destruction of genicular nerve branches using a neurolytic agent, including imaging guidance if performed.
Modifier 52 (reduced services) is applicable if not all three genicular nerve branches are treated.
Medical necessity for this procedure is established when conservative treatment options have failed to alleviate chronic knee pain resulting from osteoarthritis, degenerative joint disease, or post-surgical complications.Documentation should clearly show the failure of conservative measures before the neurolytic procedure was considered.
The physician is responsible for pre-procedure preparation, selecting appropriate nerve branches for neurolysis, utilizing the chosen neurolytic technique(s), ensuring hemostasis, and post-procedure care. Imaging guidance may be utilized.Accurate documentation of the procedure is crucial for proper coding.
In simple words: This code covers a procedure to relieve knee pain by destroying specific nerves around the knee joint using heat, chemicals, or radio waves.A doctor uses imaging (like X-rays) to guide the procedure.If the doctor doesn't treat all the targeted nerves, an additional code is added to the claim.
This CPT code reports the destruction of genicular nerve branches using a neurolytic agent (e.g., chemical, thermal, electrical, or radiofrequency ablation).The procedure involves targeting the superolateral, superomedial, and inferomedial genicular nerve branches. Imaging guidance (fluoroscopy, ultrasound, etc.) is included in the code if performed.If not all three branches are destroyed, modifier 52 (reduced services) must be appended.This procedure is used to treat knee pain related to osteoarthritis, degenerative joint disease, or post-surgical knee pain.
Example 1: A patient presents with chronic knee pain due to osteoarthritis. The physician performs radiofrequency ablation of the superolateral, superomedial, and inferomedial genicular nerve branches under fluoroscopic guidance. Code 64624 is reported., A patient experiences persistent knee pain after a total knee replacement.The physician performs chemical neurolysis of the superolateral and superomedial genicular nerve branches.Code 64624-52 (with modifier 52 for reduced services) is reported because not all three branches were treated., A patient has degenerative joint disease in the knee, causing significant pain. The physician utilizes a combination of thermal and chemical neurolysis to destroy the superolateral, superomedial, and inferomedial genicular nerve branches. Code 64624 is reported.
* Detailed operative report specifying the neurolytic agent(s) used.* Identification of each genicular nerve branch treated (superolateral, superomedial, inferomedial).* Documentation of imaging guidance (if used).* Note if modifier 52 is used and justification for reduced services.* Pre-operative and post-operative diagnoses and assessments.* Patient history related to knee pain.
** Accurate documentation is crucial for proper coding and reimbursement.Ensure the operative report clearly specifies the technique(s) utilized, the nerve branches treated, and the reason for any use of modifier 52.Payer-specific policies may influence coding and reimbursement.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- RVU: Information not available in provided text.Consult the current Medicare Physician Fee Schedule for RVU values.
- Global Days: Information not provided.The global period will vary depending on payer and may require further clarification.Consult payer-specific guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Information not available in provided text. Consult historical fee schedules and payer-specific guidelines.
- Specialties:Anesthesiology, Pain Management, Orthopedics, Neurosurgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)