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The procedure described by CPT® Code 64632 involves the destruction of the plantar common digital nerve using a neurolytic agent, typically ethyl alcohol. This intervention is primarily aimed at alleviating pain in the interdigital space, which is often associated with conditions such as Morton's neuroma. Morton's neuroma is a painful condition that affects the nerves between the toes, leading to discomfort and a burning sensation. The procedure is performed with the patient in a supine position, ensuring comfort and accessibility to the foot. The knee is flexed and supported with a pillow, while the foot is kept in a relaxed neutral position to facilitate the accurate placement of the needle. The clinician palpates the interdigital spaces to identify areas of tenderness or fullness, which may indicate the presence of a neuroma. The technique involves careful insertion of the needle at a specific anatomical location, ensuring that the neurolytic agent is delivered precisely to the target nerve. The use of a neurolytic agent like ethyl alcohol results in chemical neurolysis, which effectively disrupts the nerve's function by causing dehydration, necrosis, and the precipitation of protoplasm, ultimately leading to pain relief for the patient.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 64632 is indicated for the treatment of pain in the interdigital space, particularly in cases where patients experience discomfort due to conditions such as:
The procedure begins with the patient positioned supine, which allows for optimal access to the foot. The clinician flexes the patient's knee and supports it with a pillow, ensuring that the foot is maintained in a relaxed neutral position. This positioning is crucial for the accurate identification of the target nerve. The clinician then palpates the interdigital spaces, carefully noting any areas of tenderness or fullness that may indicate the presence of a neuroma. Once the appropriate site is identified, the needle is inserted on the dorsal surface of the foot. The insertion point is located 1 to 2 cm proximal to the web space and aligned with the metatarsophalangeal joints. The needle is held at an angle of approximately 45 degrees and advanced through the mid web space at the plantar aspect of the foot. The clinician continues to advance the needle until it tents the skin, at which point the needle is withdrawn approximately 1 cm to ensure proper placement. It is essential to avoid the plantar fat pad during this process to minimize discomfort and complications. Following the correct positioning of the needle, a neurolytic agent, such as ethyl alcohol, is injected in a mixture with an anesthetic. The neurolytic agent works by causing chemical neurolysis of the plantar common digital nerve, leading to dehydration, necrosis, and precipitation of protoplasm, which effectively disrupts the nerve's function and alleviates pain.
After the procedure, patients may experience immediate relief from pain, although some may have temporary discomfort at the injection site. It is important for patients to follow any post-procedure care instructions provided by the clinician, which may include rest and avoiding strenuous activities for a specified period. Monitoring for any adverse reactions or complications, such as infection or excessive swelling, is also essential. Patients should be advised to report any unusual symptoms to their healthcare provider promptly. The expected recovery time can vary, but many patients find significant improvement in their symptoms within a few days following the procedure.
| Short Descr | N BLOCK INJ COMMON DIGIT | Medium Descr | DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE | Long Descr | Destruction by neurolytic agent; plantar common digital 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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 | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
| LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. 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. | 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. | 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.) | T2 | Left foot, third digit | T7 | Right foot, third digit | T6 | Right foot, second digit | 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). | T1 | Left foot, second digit | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | 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.) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | JZ | Zero drug amount discarded/not administered to any patient | KX | Requirements specified in the medical policy have been met | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q8 | Two class b findings | Q9 | One class b and two class c findings | T3 | Left foot, fourth digit | T4 | Left foot, fifth digit | T5 | Right foot, great toe | T8 | Right foot, fourth digit | TA | Left foot, great toe | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | 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 | 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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| 2011-01-01 | Changed | Short description changed. |
| 2009-01-01 | Added | - |
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