Ganglion impar cpt

[paindoctor2014]

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What are y’all using

 

[JelloIsJigglin]

i would like to know this as well. Also, what code for sacrococcygeal RFA? 64640?

 

[Multimodal]

I only do cash for this procedure now. no one covers ganglion impar procedures in WA state anymore. I think cancer pain might be covered but thats it. like genicular and SIJ for some insurances, its "experimental".......le sigh

 

[nvrsumr]

used to bill as LSB now sacrococcygeal joint injection

 

[No_Pain_No_Gain]

What are y’all using

Generally 64999. There are a couple of commercial insurances that may still reimburse for 64520.

 

[painfree23]

Generally 64999. There are a couple of commercial insurances that may still reimburse for 64520.

Is 64999 ever reimbursed?

 

[Taus]

Is 64999 ever reimbursed?

I used to bill as sympathetic block. Lots of denials last few years. Now just put as small joint and “other peripheral nerve block” 64450 with 59 modifier. I inject the articulation/ligaments and the impar together. Plus fluoro spine code.

 

[Dr. Ice]

For those doing genicular rfa, since 64454 and 64624 are “experimental” are there any other codes that you are using? 64450 i suppose could be used for the block, but what about rfa? And for those of you charging cash, what are you charging? Any of you charging cash performing the rfa in an asc?

 

[Agast]

For those doing genicular rfa, since 64454 and 64624 are “experimental” are there any other codes that you are using? 64450 i suppose could be used for the block, but what about rfa? And for those of you charging cash, what are you charging? Any of you charging cash performing the rfa in an asc?

Don’t change the code, you won’t withstand an audit. I had one patient willing to pay cash at the ASC.

 

[bedrock]

For those doing genicular rfa, since 64454 and 64624 are “experimental” are there any other codes that you are using? 64450 i suppose could be used for the block, but what about rfa? And for those of you charging cash, what are you charging? Any of you charging cash performing the rfa in an asc?

Agree with agast. Don't change the code. The blocks are paid for by most insurance with the correct code.

The ablation is the issue, virtually all non regular medicare insurance plans don't cover it (including medicare advantage plans). I've done a couple genicular ablations for cash in the ASC, however most patients aren't excited about a yearly cash cost.

Unless they are bone on bone, I do regenerative medicine for cash before genicular for cash, because if the regen med works, it works for longer than a year

 

[Dr. Ice]

Where I am, the blocks are also experimental

 

[bedrock]

Where I am, the blocks are also experimental

what state is that? 100% of all commercial insurances?

 

[Dr. Ice]

NJ..I can’t say for sure if it’s all insurances, but many of them are stating experimental

 

[cowboydoc]

For those doing genicular rfa, since 64454 and 64624 are “experimental” are there any other codes that you are using? 64450 i suppose could be used for the block, but what about rfa? And for those of you charging cash, what are you charging? Any of you charging cash performing the rfa in an asc?

About $500 around here in office.

 

[Dr. Ice]

Anyone offering peripheral nerve stim for these people?

 

[Orin]

Anyone offering peripheral nerve stim for these people?

Sacral neuromodulation if concomitant functional issues, DRG if just pain

 

[DesertDoc16]

Anyone offering peripheral nerve stim for these people?

I’ve had some success with genicular PNS for post-arthroplasty knee pain, but it seems like most insurances won’t cover PNS either.

In regard to the OP, what levels have you all targeted with DRG for pelvic/perineal pain? I would think bilateral S2 DRG would work best?