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The procedure described by CPT® Code 64620 involves the destruction of an intercostal nerve, which is a critical intervention aimed at alleviating chronic pain. This procedure is particularly relevant for patients suffering from pain syndromes that are resistant to conventional treatments. The destruction can be achieved through various methods, including the injection of a neurolytic chemical agent or the application of thermal, electrical, or radiofrequency techniques. Among these, radiofrequency destruction has emerged as the most commonly utilized technique due to its effectiveness and precision. The process begins with the careful introduction of an electrode needle through the skin, which is then advanced toward the specific neural tissue targeted for intervention. This step is crucial as it ensures that the procedure is performed accurately, minimizing potential complications. The electrode needle is connected to a generator that facilitates motor and sensory testing, confirming the correct positioning at the nerve responsible for the patient's pain. Once the appropriate nerve pathway is identified, the destruction of the nerve is executed, either through the injection of a neurolytic agent—such as phenol, ethyl alcohol, glycerol, ammonium salt compounds, or hypertonic or hypotonic solutions—or through the application of heat generated by thermal or electrical modalities. In the case of radiofrequency nerve destruction, the electrode needle is adjusted to achieve optimal positioning before activating the radiofrequency device, which generates an electric current that produces heat at the electrode's tip, effectively destroying the targeted nerve tissue. This comprehensive approach to nerve destruction is designed to provide significant relief from chronic pain, enhancing the quality of life for patients affected by debilitating pain conditions.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 64620 is indicated for the treatment of chronic pain conditions that may not respond adequately to conservative management strategies. The following are specific indications for performing intercostal nerve destruction:
The procedure for intercostal nerve destruction using CPT® Code 64620 involves several critical steps to ensure effective treatment and patient safety. The following outlines the procedural steps:
After the intercostal nerve destruction procedure, patients are typically monitored for a short period to assess for any immediate complications or adverse reactions. Post-procedure care may include instructions for pain management, which can involve the use of analgesics as needed. Patients are advised to avoid strenuous activities for a specified period to allow for proper healing. Follow-up appointments may be scheduled to evaluate the effectiveness of the procedure and to monitor the patient's recovery. It is essential for patients to report any unusual symptoms or complications, such as increased pain or signs of infection, to their healthcare provider promptly.
| Short Descr | INJECTION TREATMENT OF NERVE | Medium Descr | DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE | Long Descr | Destruction by neurolytic agent, intercostal nerve | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 1 - Statutory 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 | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 5 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
| 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). | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code 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 | CG | Policy criteria applied | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | SG | Ambulatory surgical center (asc) facility service | 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 |
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| 2014-01-01 | Changed | Guideline Information Changed. Corrected transposed code 64333 to 64633 per AMA 2014 corrections document posted 2014-03-24 |
| Pre-1990 | Added | Code added. |
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