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Ablation, specifically percutaneous cryoablation, is a medical procedure designed to alleviate chronic nerve pain. This minimally invasive technique employs imaging guidance to accurately target the affected nerve(s). During the procedure, a specialized instrument known as a cryoprobe is utilized. The cryoprobe is a hollow needle that delivers a cooling agent, which can be helium, argon, or liquid nitrogen, directly to the targeted nerve. The primary goal of cryoablation is to destroy the myelin sheath surrounding the nerve, effectively interrupting the transmission of pain signals to the brain. The procedure begins with the insertion of one or more cryoprobes through the skin, guided by imaging technology to ensure precise placement. The correct positioning of the probes may be verified through a nerve stimulation test, which confirms that the targeted nerve is accurately located. Once the probes are in place, a pressurized coolant is released, forming an ice ball at the tip of the probe. This ice ball expands and freezes the surrounding tissue, leading to the desired ablation effect. After the procedure, the cryoprobes are carefully removed, completing the process. It is important to note that there are specific CPT® codes associated with this procedure, including code 0440T for upper extremity nerves, code 0441T for lower extremity nerves, and code 0442T for nerve plexus or other truncal nerves, such as the brachial plexus or pudendal nerve.
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The percutaneous cryoablation procedure is indicated for patients experiencing chronic nerve pain that has not responded to conservative treatment options. This procedure is particularly beneficial for individuals suffering from conditions that affect the lower extremity distal or peripheral nerves.
The percutaneous cryoablation procedure involves several key steps to ensure effective treatment of the targeted nerve(s). Initially, the patient is positioned appropriately to allow access to the lower extremity. Imaging guidance, such as ultrasound or fluoroscopy, is employed to visualize the anatomy and accurately locate the nerve to be treated. Once the target nerve is identified, a local anesthetic may be administered to minimize discomfort during the procedure.
Following the cryoablation procedure, patients may experience some discomfort or swelling at the site of the treatment. It is important for healthcare providers to monitor the patient for any immediate complications. Patients are typically advised to rest and may be given specific instructions regarding pain management and activity restrictions. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and to monitor the patient's recovery. The expected recovery time can vary, but many patients report a reduction in pain symptoms within a few days to weeks following the procedure.
| Short Descr | ABLTJ PERC LXTR/PERPH NRV | Medium Descr | ABLTJ PERC CRYOABLTJ IMG GDN LXTR/PERPH NERVE | Long Descr | Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve | Status Code | Carriers Price the Code | Global Days | YYY - Carrier Determines Whether Global Concept Applies | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 3 |
| X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | RT | Right side (used to identify procedures performed on the right side of the body) | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) |
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| 2017-01-01 | Added | First appearance in codebook. |
| 2016-07-01 | Added | Code Added. |
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