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Rfa s5 and coccygeal nerves

Orin

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This is to denervate the coccyx? I would support 64640 as a peripheral nerve ablation. There is no facet joint to dennervate and I'm not sure how many units

64625 would be the SI Joint and 64635 would be the lumbosacral facet joint code, but neither make sense if you're targeting S5/Co1-?
 
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chibadriver

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  1. Attending Physician
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Ferrismonk

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64640x2. I get both sides. I've only done this once, but it worked very well. Used a technique on this board in another thread. Patient had continued coccydynia despite conservative treatment. Impar steroid was ineffective, coccyx intraarticular helps for a few months only.

On a related note, how do you RF the impar? Do you just punch through the ligament/joint or do you wrap around somehow? Seems to me bowel injury is a high risk and I'm not a fan of chemical ablation.
 
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