2025 CPT code 64633
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Destruction of a single cervical or thoracic paravertebral facet joint nerve using a neurolytic agent, guided by fluoroscopy or CT.
Modifiers 50 (bilateral procedure) and others as clinically indicated should be applied appropriately.
Medical necessity for this procedure must be established by documentation showing that conservative treatment options (e.g., physical therapy, medication) have failed to provide adequate pain relief.The patient's pain must be significantly impacting their daily life and functional abilities.Documentation should support the diagnosis of chronic facet joint pain and the rationale for the procedure.
The physician is responsible for patient preparation and anesthesia, precise needle placement under fluoroscopic or CT guidance, identification of the target nerve, and execution of the neurolytic procedure using appropriate technique(s) to destroy the nerve.Post-procedural hemostasis is also the physician's responsibility.
In simple words: This code describes a procedure to eliminate pain by destroying a nerve near the spinal joints in the neck or upper back.A doctor uses imaging (like X-rays or CT scans) to guide a needle to the nerve. Then, they use heat, electricity, or a special medicine to destroy the nerve.
This CPT code, 64633, reports the destruction of a single paravertebral facet joint nerve in the cervical or thoracic spine using a neurolytic agent.The procedure involves the use of image guidance, either fluoroscopy or CT, to precisely target the nerve.Neurolytic agents may include heat, electric current, or chemical compounds.This is a unilateral procedure; for bilateral procedures, report 64633 with modifier 50.Additional facet joints at different vertebral levels within the same spinal region require the use of code 64634 for each additional joint.
Example 1: A 55-year-old female presents with chronic cervical radiculopathy and intractable neck pain unresponsive to conservative treatment.After thorough evaluation, the physician performs a thermal radiofrequency ablation of a single cervical paravertebral facet joint nerve under fluoroscopic guidance using code 64633., A 62-year-old male with chronic thoracic pain undergoes a chemical neurolysis of a single thoracic paravertebral facet joint nerve using code 64633. CT guidance is utilized for accurate needle placement., A 48-year-old female with chronic pain affecting multiple thoracic facet joints undergoes a series of procedures. Code 64633 is used for the initial single-level ablation, while code 64634 is added for the second level completed on the same day.
Detailed history and physical examination, including pain location, character, duration, and response to previous treatments.Radiological images (X-ray, CT, MRI) showing the affected facet joint(s) and evidence of nerve involvement.Pre-procedural consent form documenting the risks and benefits.Procedure report detailing the technique used, the specific nerves targeted, and any complications. Post-procedural assessment and follow-up documentation.Pain assessments before and after the procedure.
** The information provided is based on the available source material, which may not be exhaustive.Always consult the most current CPT codebook and payer guidelines for accurate billing and coding practices.Be aware of payer-specific requirements and any local coverage determinations (LCDs) that may apply.
- Revenue Code: P5E (Ambulatory Procedures - Other)
- RVU: This information is not available in the provided text.Consult the AMA CPT codebook or your payer's fee schedule for RVU values.
- Global Days : The provided text does not specify the global surgical period for this procedure.This should be determined based on payer guidelines and local practice.
- Payment Status: Active
- Modifier TC rule: This information is not available in the provided text. Consult AMA CPT coding guidelines or your local payer's guidelines.
- Fee Schedule : This information is not available in the provided text. Consult the AMA CPT codebook or your payer's fee schedule for historical fee data.
- Specialties:Pain Management, Anesthesiology, Neurosurgery
- Place of Service:Office, Ambulatory Surgery Center, Hospital Outpatient Department