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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 specific nerves, such as those in the brachial plexus or pudendal nerve. The procedure utilizes a specialized instrument known as a cryoprobe, which is a hollow needle that delivers a cooling agent—commonly helium, argon, or liquid nitrogen—directly to the affected nerve(s). The primary goal of cryoablation is to destroy the myelin sheath surrounding the nerve, effectively interrupting the transmission of pain signals to the brain. During the procedure, one or more cryoprobes are inserted 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 helps confirm 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 that freezes the surrounding tissue. This freezing process not only disrupts the nerve's ability to send pain signals but also promotes healing in the affected area. After the procedure, the cryoprobes are carefully removed, concluding the treatment. This code, 0442T, specifically pertains to the ablation of nerve plexus or other truncal nerves, distinguishing it from codes 0440T and 0441T, which are designated for upper and lower extremity nerves, respectively.
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The procedure of percutaneous cryoablation is indicated for patients experiencing chronic nerve pain that may be associated with various conditions affecting nerve function. The following are specific indications for this procedure:
The percutaneous cryoablation procedure involves several critical steps to ensure effective treatment of the targeted nerve(s). The following outlines the procedural steps:
After the completion of the percutaneous cryoablation procedure, patients are typically monitored for a short period to ensure there are no immediate adverse effects. Post-procedure care may include instructions for pain management, activity restrictions, and signs of complications to watch for, such as increased pain or signs of infection at the insertion site. Patients may experience some swelling or discomfort in the treated area, which is generally manageable with over-the-counter pain relief. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and to determine if additional treatments are necessary for optimal pain relief.
| Short Descr | ABLTJ PERC PLEX/TRNCL NRV | Medium Descr | ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV | Long Descr | Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal 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 |
| 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. | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) | 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 | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2017-01-01 | Added | First appearance in codebook. |
| 2016-07-01 | Added | Code Added. |
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