Hip and Knee RF Experimental?

[drusso]

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Two health plans (Gigna and Providence) in my region now not covering hip/knee RF. What are others seeing?

From now on, I'm just recommending that patients pay cash for the service like Regen.

Considered Experimental/Investigational/Unproven when used for the treatment of pain

conditions as outlined in the above coverage policy statement: CPT®* Codes	Description
0441T	Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve
64632	Destruction by neurolytic agent, plantar common digital nerve
64640	Destruction by neurolytic agent; other peripheral nerve or branch

Cigna has joined Providence in not covering knee/hip RFA’s

 

[Ferrismonk]

Wow, all 64640?

Curious, what will you charge for RFA? Will you still do diagnostic blocks first if they're cash pay?

 

[drusso]

Wow, all 64640?

Curious, what will you charge for RFA? Will you still do diagnostic blocks first if they're cash pay?

The blocks are still covered. So, I'll just come up with a fair price for the burns if the blocks work. No HOPD SOS fee so it will be a bargain.

 

[SommeRiver]

I rarely do geniculars bc my reimbursement for them...I'm sorry...Make them not worth my time. I do them occasionally, but it hurts me.

 

[bedrock]

The word from Avanos is they are quite certain there will be a specific 2020 code for RF of both the Knee and SIJ. (they've been working on this for years). I'm not certain if this code will only apply to cooled RF.

This might help you get paid for your knees