You have requested access to member-only content.

Q&A: Dual coding pain management with CPT and ICD-10-PCS

Q: We are coding for pain management procedures and have been doing dual coding in ICD-9-CM and CPT®. With a medial branch block ablation at two levels for L3-L4 and L4-L5 for a bilateral injection, we are coding:

  • ICD-9-CM procedure code 04.2 (destruction of cranial and peripheral nerves)
  • CPT codes 64635 (destruction by neurolytic agent, paravertebral facet joint nerve[s], with imaging guidance [fluoroscopy or CT]; lumbar or sacral, single facet joint) and 64636 (destruction by neurolytic agent, paravertebral facet joint nerve[s], with imaging guidance [fluoroscopy or CT]; lumbar or sacral, each additional facet joint [List separately in addition to code for primary procedure]), each with modifier -50 (bilateral procedure) appended.

What would be your recommendation for the ICD-10-PCS code? Currently we are coding 015B3ZZ (destruction, lumbar nerve, percutaneous) twice. We are not sure if we should be picking this code up twice or only once.  

This is an excerpt from member-only content. Please log in or become a member.

Not a member? Let's fix that!

JustCoding is the continuing education website for coding professionals. Whether you're an inpatient or outpatient coder, a veteran or new to the job, JustCoding will keep your skills sharp, test your coding knowledge, and help you stay abreast of CMS changes.

Register to access the free content available through the JustCoding site or subscribe to a Basic or Platinum membership to access paid content on this site. Click here for more information.

For questions and support, please call customer service: 800-650-6787.