2025 CPT code 64629
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Thermal destruction of an additional intraosseous basivertebral nerve in the lumbar or sacral spine, following the initial two vertebral bodies treated in the same session.
Modifiers may be applicable depending on the circumstances of the procedure.Consult the AMA CPT manual and payer-specific guidelines for details on appropriate modifier usage.Examples include modifiers for anesthesia (47), reduced services (52), or multiple procedures (99).
Medical necessity for basivertebral nerve ablation is established through a thorough clinical evaluation demonstrating chronic lower back pain refractory to conservative management, consistent with the findings on appropriate imaging studies. The procedure is typically considered medically necessary when the patient has failed to respond to conservative treatments such as physical therapy, medication, and injections.
The physician's responsibilities include pre-operative evaluation, obtaining informed consent, performing the procedure under image guidance, and post-operative care. This may include assessing the patient's pain levels, determining the need for additional treatments, and providing appropriate post-operative instructions.
- Surgery
- Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) Procedures on the Somatic Nerves
In simple words: This code describes a procedure to relieve lower back pain.A doctor uses heat to destroy a small nerve in your spine that causes pain. This code is only used if the doctor already treated the first two nerves in the same visit; this code is for any additional nerves treated after the first two.
This CPT code, 64629, reports the thermal destruction (ablation) of each additional intraosseous basivertebral nerve in the lumbar or sacral spine using image guidance.This code is an add-on code and should only be reported in conjunction with CPT code 64628 (initial two vertebral bodies). The procedure involves inserting a specialized cannula through the vertebral pedicle to reach the basivertebral nerve, followed by the application of a thermal energy source (e.g., radiofrequency) to destroy the nerve.Imaging guidance (e.g., fluoroscopy) is used throughout the procedure. This code represents each additional vertebral body treated after the first two, within the same session.
Example 1: A patient presents with chronic lower back pain. After a thorough evaluation, the physician determines that basivertebral nerve ablation is appropriate.The physician performs the procedure on two vertebral bodies using CPT code 64628.During the procedure, it is determined that treatment of three additional vertebral bodies is necessary to achieve adequate pain relief.Therefore, CPT code 64629 is reported three times, in addition to 64628., A patient with severe lower back pain related to degenerative disc disease undergoes basivertebral nerve ablation. The physician determines that treatment of four vertebral bodies is needed.CPT code 64628 is reported for the first two vertebral bodies, and CPT code 64629 is reported twice for the additional two vertebral bodies., A patient presents with chronic lower back pain stemming from a prior spinal fusion surgery. After assessment, the physician recommends basivertebral nerve ablation.One vertebral body requires treatment. CPT code 64628 is reported for the initial procedure, and CPT code 64629 is not reported in this case because only one vertebral body was treated.
** This code describes a procedure for the treatment of vertebrogenic lower back pain. Accurate documentation is crucial for appropriate reimbursement. Always verify payer-specific coverage and coding policies before submitting claims.
- Revenue Code: P6C (Minor Procedures - Other)
- RVU: RVUs will vary based on geographic location and other factors. Consult a local fee schedule or Medicare payment system for current values.
- Global Days: The global period is not explicitly defined for this add-on code; it is dependent on the global period associated with the primary procedure (CPT 64628).
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Fee schedules vary based on location and payer.Consult the appropriate fee schedule for the relevant date.
- Specialties:Pain Management, Neurosurgery, Orthopedic Surgery
- Place of Service:Office, Ambulatory Surgery Center, Hospital Outpatient Department