Paravertebral Joint/Nerve Denervation

by  Find-A-Code
January 10th, 2018

According to Medicare article A50443, a facet joint is supplied by two medial branch nerves. Each medial branch nerve supplies sensation to one half of each facet joint above and below the spinal nerve of origin. Therefore, both of the two related medial nerve branches for each facet joint must be treated. 

The CPT codes 64635-64636 have a bilateral surgery indicator of "1." Thus, they are considered “unilateral” procedures and the 150% payment adjustment for bilateral procedures applies.

Whether a paravertebral facet joint/nerve denervation is performed unilaterally or bilaterally, use CPT code 64635 or 64636 for the first level denervated. If a second level is denervated unilaterally or bilaterally, use CPT code 64636 or 64634.

Injecting any denervation agent through the needle, including small amounts of contrast or anesthetic to confirm the position of the needle is considered an integral part of the procedure and is not separately reimbursed. Neither the injection procedure nor the anesthetic or denervation agent drugs should be billed.


Paravertebral Joint/Nerve Denervation. (2018, January 10). Find-A-Code Articles. Retrieved from

© InnoviHealth Systems Inc

Article Tags  (click on a tag to see related articles)

Publish this Article on your Website, Blog or Newsletter

This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active. If you would like to publish this article, please contact us and let us know where you will be publishing it. The easiest way to get the text of the article is to highlight and copy. Or use your browser's "View Source" option to capture the HTML formatted code.

If you would like a specific article written on a medical coding and billing topic, please Contact Us.


innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
free demo
request yours today
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.