SI joint RFA

[paindoc007]

Sorry if this has been asked before. There seems to a ton of variability on how people do their RFA for SI joint pain. I’ve been doing L5 DR and S1-2 lateral branch. But I’ve heard others doing l4-s3. Just didn’t know how excessive that would be.

Also, for billing I’ve been doing 64635, 64640x2. I’ve wondered if that’s accurate though, as I’m just burning at sacral ala, not l4 MB, so not sure if the 64635 applies if you don’t denervate the entire l5-s1 joint?

Thoughts? Thanks

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[powermd]

I bill $750 cash for SI joint RF (each side). I don't dick around with insurance on this anymore. For the time and energy you put in, peripheral nerve RF just doesn't pay enough. Most insurers won't allow it anyway.

My success rate went up quite a bit after I started including a strip lesion along the joint line, in addition to L5DR, S1-3.

 

[lobelsteve]

bipolar lesions around sacral foramen. from N to E/W for 90 sec, then E/W to S for 90. Reg RFA at ala.
6 bipolar lesions, 1 reg. That takes too long for what we get paid.

Like the idea of coolief, but not reimbursed to cover cost of equipment, and soreness takes away the first 3-4 weeks of relief.