Bilateral Genicular NB/RFAs

[SpineandWine]

Question - regarding billing. Does it matter if you use 3 needles, or 4 needles
superior lateral genicular nerve, superior medial nerve, inferior medial nerve, terminal branch of vastus medialis.

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[buddababa]

Question - regarding billing. Does it matter if you use 3 needles, or 4 needles
superior lateral genicular nerve, superior medial nerve, inferior medial nerve, terminal branch of vastus medialis.

1 cpt code for 3, 4 ,20 needles

 

[RoloTomassi]

What happens to genicular blood vessels when you ablate? Collateral damage or are they a heat sink, spared?

 

[paindoctn]

good idea, or if possible, cryo.

I don't think cryo RFA is billable. Medicare LCD guidelines are very specific about that. Even though this LCD applies to the facet joints, same applies to any other RFA Mcare guidelines.

The following are considered not reasonable and necessary and therefore will be denied:

2.Non-thermal modalities for facet joint denervation including chemical, low-grade thermal energy (less than 80 degrees Celsius), laser neurolysis, and cryoablation.

LCD - Facet Joint Interventions for Pain Management (L38803)

Use this page to view details for the Local Coverage Determination for Facet Joint Interventions for Pain Management.

www.cms.gov

 

[Ducttape]

yup


thats why i said "if possible, cryo."