AHA Coding Clinic® for HCPCS - 2019 Issue 3; For Your Information

Radiofrequency ablation at L5-S3

A patient presented for radiofrequency ablation of the lateral branches of the L5 dorsal ramus, S1, S2, and S3. Starting at the L5 dorsal ramus, using fluoroscopy, the needle was placed to the sacral ala level and advanced to the S1 superior articular process. Motor stimulation was carried out and radiofrequency lesioning of the L5 dorsal ramus was performed at 80 degrees centigrade for 90 seconds. Next, the S1 foramina was visualized using fluoroscopy. Two needles were positioned and bipolar radiofrequency was carried out at 80 degrees centigrade for 90 seconds. The exact steps were repeated at the S2 and S3 foramina. CPT coding guidelines indicate that code assignment is based upon the number of facet joints treated. However, since the sacrum is fused, there are no actual sacral facet joints below L5. What is the correct CPT code assignment for radiofrequency ablation at L5-S3? Is this procedure considered pulsed or non-pulsed? ...

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