0000000000000057. Reg Anesth Pain Med 2007; 32(6):495-503. Mar 20, 2011. Undoubtedly, denervation of the first carpometacarpal (CMC-1) joint does represent a promising surgical treatment alternative for patients suffering from persistent CMC-1-joint osteoarthritis. The denervation of the first CMC joint has gained traction as a viable treatment for CMC arthritis. 4) per month after ablation. Botulinum toxins are used in the treatment of overactive skeletal muscles, smooth muscles, and glands. Solutions . My surgeons are starting to perform AIN to Ulnar nerve transfer more often and we are trying to determine the most appropriate coding. Hand surgeons who document thumb carpometa-carpal stabilization" " "Eaton procedure" or "LRTI" in their notes often stump orthopedic coders who cannot locate any such descriptors in CPT. 03) Thumb base metacarpal fracture, open (815. Surgical Procedures on the Hand and Fingers. 001. healthcare. Wrist Denervation. 99: Rheumatoid arthritis: M12. 1 Department of Orthopaedic Surgery and Sports Medicine, Temple University Hospital, 6th Floor OPB, Philadelphia, PA, 19140, USA. Modifier 50 is not appropriate because coding is based on the number of muscles treated. Selective denervation of the thumb CMC joint is a rarely considered alternative approach that can be used to treat pain associated with CMC arthritis. 12) Carpometacarpal dislocation, closed (833. 6 months after original CMC denervation for recurrence of pain. MCP Ligament Injury Codes. Neurectomy of the dorsal radial sensory nerve articular branches. 2018. [ Read More ] Laparoscopic. To determine the innervation pattern to the thumb carpometacarpal (CMC) joint and assess the safety and efficacy of selective joint denervation for the treatment of pain and impairment associated with thumb CMC arthritis. ablation or denervation is an effective treatment for occipital neuralgia or headaches. 8 First described in 1991, thumb CMC denervation has reported success rates in the literature ranging from 35% to 87% in patients with symptomatic osteoarthritis. Objective. Arthrocentesis, aspiration and/or injection; small joint, bursa or ganglion cyst eg, fingers, toes) (20600) Basal Joint Arthroplasty. 1016/j. Description of Procedure or Service Facet joint denervation is performed under local anesthetic and with fluoroscopic guidance. Results are listed in Table 1. 4 to 6 weeks: Physical therapy begins. The Current Procedural Terminology (CPT ®) code 64721 as maintained by American Medical Association, is a medical procedural code under the range - Neuroplasty (Exploration, Neurolysis or Nerve Decompression) Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System. Europe PMC is an archive of life sciences journal literature. Trap: Some coders report 26480 for every transfer because the surgeon always transfers the tendon to the carpometacarpal area. 12 Recent attention has been placed on the role of CMC denervation in the treatment of CMC arthritis. 14 open for joint dislocation CMC and check your documentation to see if it was a dislocated joint and/or a carpal and/or a metacarpal bone. 0. Therefore, the objective of this study was to identify the articular branches supplying the thumb CMC joint and. Joint denervation presents a number of theoretical advantages over more traditional surgical options; it is minimally invasive, it does not require a prosthesis or postoperative immobilisation, and does not preclude future surgery. code only 39140-00 [32] Epidural injection forCriteria. 1007/s11552-007-9068-9. Brief – 5 minutes: 99211. Arthroplasty with prosthetic replacement, trapezium (25445) Interposition arthroplasty, intercarpal or carpometacarpal joints (25447) Partial Trapezoid excision. and Riley N. Garfield, NJ. old 115Kg 1m74, Diabetes Architect Bilateral Painful CMC OA No MCP joint hyperextension LEFT SIDE Preoperative Work Up Follow Up -2016 Immediate Post Op –2012 MALE 61 Y. Among the 6 patients who had previously undergone spinal surgery, 2 (33. These services should be reported with CPT code 64999. Fenig performs to treat this pain. 2 The most commonly involved joints are the fourth and fifth CMC joints. Since the resulting chemical denervation of muscle produces local paresis or paralysis, selected muscles can be treated. CPT code 52287 - Cystourethroscopy, with injection(s) for chemodenervation of the bladder 2018 Non-Facility (Office), Medicare Nat’l Average . The hand is frequently injured. radiofrequency denervation: a multi-center analysis. 53 - other international versions of ICD-10 M26. Arthrotomy, elbow, for infection, with exploration, drainage or removal of foreign body (24000) Arthrotomy of the elbow, with capsular excision for capsular release separate procedure (24006) Arthrotomy, elbow; with synovial biopsy only (24100) Arthrotomy, elbow; with joint exploration, with or without biopsy. Arthroplasty with prosthetic replacement, trapezium (25445) Interposition arthroplasty, intercarpal or carpometacarpal joints (25447) Partial Trapezoid excision. . 3. Medial calcaneal sensory. 0001). 7) Late effect, arm fracture (nonspecific) (905. CMC Arthrodesis. 1. Occipital Nerve (CPT Code 64744) for Treatment of Headaches . Interposition arthroplasty, intercarpal or carpometacarpal joints (25447) Revision of arthroplasty, including removal of implant, wrist joint (25449) Arthrodesis, wrist joint (including radiocarpal and/or ulnocarpal fusion); with iliac or other autograft (includes obtaining graft) (25810) Arthrodesis and resection of radioulnar joint (25830)Thumb carpometacarpal osteoarthritis (CMCJ OA) is a common problem. 1 “primary arthrosis of first carpometacarpal joint, unilateral “ M25. Case 2 (urodynamic): 51729, 51741, 51784, 51797, 52000. You may report only a single unit of either 64646 or 64647, per session. Hand function may be hampered by osteoarthritis inthe first carpometacarpal joint. 01. Trapeziectomy as a treatment of first carpal-metacarpal (CMC) joint has been reported for almost 70 years . 1 ). Coding Submenus Contusion; Sprain / Strain / Ligament Injuries; ICD9 Codes Thumb base metacarpal fracture, closed (815. Wrist Denervation. High revision rates with the metal-on-metal Motec carpometacarpal joint prosthesis. Search by ICD9. The BP-lowering effect of renal denervation was sustained for up to 3 years. 6 months, pain was reduced from mean of 8. I agree with 20600 for the CMC injection code. Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant (P < . 2018. Introduction. Pain scores for AKP were significantly better in the denervation group at 3 months but not at 12 and 24 months. Long-term follow-up after ligament reconstruction with tendon interposition. In an inpatient facility reimbursement for HCPCS code V2790 is included in the Outpatient Prospective Payment System (OPPS) allowance. 25449 . The chart below identifies which trade name. There was 3. PMCID: PMC2527221. Well-. Hand Surgery CPT Codes, sorted by number. Vaseghi M, Zhou W, Shi J, Ajijola OA, Hadaya J, et al. Besides denervation and arthrodesis, arthroplasty is a valuable alternative treatment. Microsurgical denervation of the spermatic cord is one surgical treatment Dr. Hypertension (HTN) affects approximately 50% of the adult population and is one of the most important contributors to cardiovascular morbidity and mortality. DOI: 10. 25% bupivacaine. 26841. 53 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. To apply the principles of therapeutic joint denervation to treat thumb CMC arthritis, a basic understanding of the innervation patterns to the CMC joint is needed. This study was designed to compare functional outcomes, pain reduction, and quality of life between denervation and suspension arthroplasty in patients treated for thumb carpometacarpal. 3 The avascular. Skin and subcutaneous tissue were elevated from the. CPT Code Description : 25280 : Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon . and/or intercarpal and/or carpometacarpal joints) 21. In all studies, joint denervation improved pain and hand function at follow-up (M = 36. 51 cm and 3. Hardware CPT Codes. 61 ± 2. 7) Arthrotomy, distal radioulnar joint for repair of triangular cartilage complex (25107)CPT Codes. 1097/00130911-200303000-00006. All patients demonstrated improved grip strength at diagnostic injection. J Hand Surg. New Haven, IN. 53 may differ. All patients demonstrated improved grip strength at diagnostic injection. For the study cohort, the conversion rate to T + LRTI at 2 years was 9%. (2012) Sympathetic innervation of the anterior left ventricular wall by the right and left stellate ganglia. Release Skin / Fascia; Release Tendon / Muscle; Release Joint; Contractures Basal joint / First web space; Boutonniere; Burn; Dupuytren'sFrom AMA CPT 2020: “For bilateral paravertebral facet injection procedures, report 64490, 64493 with modifier 50. 2). 10. These services should be reported with CPT code 64999. 2018. Patient satisfaction was higher in the denervation group. Aug 11, 2020 #1 Hello, I'm trying to figure out which cpt code better fits. Debridement CPT Codes. 4) per month after ablation. 1 cm to 30. Non-thermal facet joint denervation (including chemical, low grade thermal energy [<80 degrees Celsius] or any other form of pulsed radiofrequency) should not be reported with CPT codes 64633, 64634, 64635 or 64636. 001) reduction in pain scores from baseline (M = 6. jhsa. 2 (5. We investigated the effect of an extended denervation procedure in the thumb carpometacarpal (CMC) joint in patients suffering from CMC osteoarthritis. Facet Joint Denervation: The thermal radiofrequency destruction of cervical, thoracic, or lumbar paravertebral facet joint (medial branch). Jan 27, 2020. However, the innervation pattern of the thumb CMC joint is controversial. Sixteen case series reported positive outcomes with respect to pain, function and patient satisfaction. Suture was tied over the bridge between the 2 smaller holes. Hand osteoarthritis—a heterogeneous disorder. . Exploration of penetrating extremity wound separate procedure (20103) Superficial Debridement. 43) Crushing injury, wrist (927. CPT has several codes (64732-64772) relating to the excision or transection of the nerves. e8. 3. 27). #5. 12) Carpometacarpal dislocation, closed (833. Diagnosis is made clinically with a painful CMC grind test and radiographs of the hand showing osteoarthritis of the 1st CMC joint. Jan 17, 2012. the hemitrapeziectomy is an arthrodesis of the 1st CMC. Background: Joint denervation of the wrist, basal joint of the thumb, and the finger is an option for patients with chronic pain. " See CPT Assistant February 2015/Volume 25 Issue 2. Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant (P < . Denervation of the thumb CMC joint has emerged as a viable treatment option. The procedure can take 2 to 3 hours to perform. [ 59] described three components of the revision procedure for failed thumb CMC arthroplasty: (1) preserving the space flanked by the metacarpal and scaphoid, (2) identifying and addressing any underlying scaphotrapezoid joint arthritis, and (3) treating MCP hyperextension. All patients who underwent first CMC joint denervation surgery from January 2015 through September 2017 were retrospectively identified. He mentioned only the superficial branch of the radial nerve (SBRN) to supply the thumb CMC joint and reported 87% good results in 170 patients. Neurectomy of the anterior interosseus nerve. Arthrotomy, for infection, with exploration, drainage or removal of foreign body; carpometacarpal joint (26070) Arthrotomy, for infection, with exploration, drainage or removal of foreign body; metacarpophalangeal joint (26075) Arthrotomy, for infection, with exploration, drainage or removal of foreign body; interphalangeal joint, each (26080)This pain affects the quality of life in 2. 25447 Includes Trapezium Excision. Innervation of the dorsal aspect of the wrist joint. 04Conclusion Thumb CMC denervation provides effective relief of arthritis pain that was durable at 5+ years after surgery in more than half of our initial cohort of patients treated. 4. An instruction was discovered in the Medicare MAC NGS Coding Article 52863 Pain Management related to the new sacroiliac RFA code. }, author={Raymond Rath and Max Haerle. Radiographic changesinclude. 008. This article was converted to the new Billing and Coding Article type. American Society for Surgery of the Hand assh. Coding Table 3 lists ICD-10-CM. Carpometacarpal (CMC) dislocations are an uncommon injury, composing less than 1% of all hand and wrist injuries. 11. 1 The socioeconomic burden of OA is high, at least 4. High complexity – 40 minutes: 99215. May 22, 2017. 65 preop to 0. 11. Denervation of the proximal interphalangeal joint: a realistic and simple procedure. Respir Res. @article{Rath2022DenervationOT, title={Denervation of the thumb carpometacarpal joint for symptomatic osteoarthritis in 46 patients. What are the risks of CMC ligament repair? You may bleed more than expected or get an infection. Partial denervation can be performed with one or two incisions and typically involves transection of the posterior and anterior interosseous nerves. interosseous nerve. Contracture Release Codes. Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Clinical Outcomes and Cadaveric Study J Hand Surg Am . We read with great interest the recent systematic review by Teo I. The purpose of this study is to analyse the evidence for thumb CMCJ denervation; evaluating patient selection, surgical techniques, complications and outcomes. The CMC joint of the thumb is a saddle joint. 01) Metacarpal base fracture, closed (815. 01. 2) Late effect of. 1 The SLL is C-shaped and has three structurally distinct parts: volar; membranous; and dorsal ( Fig. org The Best Resource For Your Hands, Period. Rather, the provider of these therapies must bill with CPT code 64455 or 64632 Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton's neuroma) as the correct CPT code for the service. 69 ± 1. Specific attendings will perform their preferred technique for CMC arthritis: two perform denervation of the CMC joint, and two perform trapeziectomy with ligament reconstruction tendon-interposition (LRTI) only per their normal clinical practice. 61 ± 2. non-operative or surgical) during their lifetime. doi: 10. Report add-on codes 64491, 64492, 64494, 64495 twice, when performed bilaterally. #3. Results: A total of 9 patients and 11 first CMC joints underwent this operation. interosseous nerve. From an Orthopedic standpoint, "arthritis of the base of the thumb" most likely & commonly refers to arthritis of the First Carpometacarpal Joint of the thumb, M18. 1,2 Blood pressure (BP) remains sub-optimally controlled in up to 25% of these patients, often attributed to medical non-adherence and resistant disease despite appropriate medical. Z Disclaimer Please note this question was answered in 2019. Both codes 62263 and 62264 should be reported only one time for the entire series of injections, infusions, or mechanical lysis procedures performed, not per adhesiolysis treatment. Lateral antebrachial cutaneous nerve. 04 _) is rare by comparison, though it. 2021;22(1):62. 01. Basilar Thumb Arthritis is a form of arthritis that causes pain at the base of the thumb and difficulty with pinching and grasping due to carpal-metacarpal (CMC) joint arthritis. on denervation in thumb carpometacarpal joint osteoarthritis. 1,2 Although debated, the cause of this condition is generally thought to be mechanical wear. 64718 includes transposition but does it include fully anastomosing the two. Sacroiliac (SI) Joint Nerve Denervation (CPT Code 64625) Medicare does not have a National Coverage Determination (NCD) for SI nerve denervation. or depending on the insurance plan use 25210 x (times) # of bones, up to 4. Ramsey SD, Berry K, Etzioni R, et al. , and the National Emphysema Treatment Trial Research Group. 21) Late effect of sprain/strain (nonspecific) (905. DIAGNOSES FOR CHEMODENERVATION PROCEDURES. Results from a consecutive series of 13 patients with thumb CMC arthritis who underwent joint denervation were retrospectively reviewed. 541 - M12. The procedure is well tolerated, with faster recovery as compared with trapeziectomy. 10. Nine studies were identified with 184 denervation procedures undertaken in 175 patients. CPT® Code Description PI 2021 Medicare National ASC Average Payment 2021 Medicare National Average Physician Payment (Facility Setting) 27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft J8 $8,833 $1,322 Ambulatory Surgical Center Physician CPT® Code. Multiple carpometacarpal dislocations. Non-thermal facet joint denervation (including chemical, low grade thermal energy [<80 degrees Celsius] or any other form of pulsed radiofrequency) should not be reported with CPT codes 64633, 64634, 64635 or 64636. If denervation is performed bilaterally, Modifier 50 should be appended to the procedure code with number of services of one. In that case, you should report 25447 with 26480 ( Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon ). More advanced disease, however, tends to require. Optum states "Code 25825 (column 1) has a CCI conflict with code 25210. Abstract and Figures. 03. Code 25442. 0) Pain in joint, forearm (719. Carpometacarpal (CMC) joint/trapeziometacarpal (TMC) joint implants: HCPCS codes not covered for indications listed in the CPB: C1776: Joint device (implantable) [carpometacarpal (CMC) joint/trapeziometacarpal (TMC)] ICD-10 codes not covered for indications listed in the CPB: M05. | Find, read and cite all the. Undoubtedly,. We present the results of a prospective study of 31 thumbs in 30 patients affected by primary osteoarthritis at the thumb carpometacarpal (CMC1) joint who were treated with denervation of the involved joint. 4 Idiopathic orofacial. You would not report 29874, 29877, 29881 or 29882 if these procedures are performed in the same compartment as the. Page 443 CPT AMA 2020 edition - definition of neuroplasty is spelled out so it's no wonder they won't pay the 24359 no matter what modifier you slap on it. Methods In this paper, we present a 4- to 6-year follow-up case. 1, Fig. #2. Fusion in opposition, thumb, with autogenous graft (includes obtaining graft) (26820) Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation (26841) Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft) (26842)All patients who underwent first CMC joint denervation surgery from January 2015 through September 2017 were retrospectively identified. In the middle third of the forearm, it lies behind the same muscle, close to the lateral side of the artery. 9, 10, 11. 10 $761 CMC Joint Fusion CPT® Code Description 2020 Total RVUs 2020 Medicare National Average Payment 26841 Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; 21. 3 ± 0. First carpometacarpal joint denervation: anatomy and surgical technique. 20612 Aspiration and/or injection of ganglion cyst(s) any location 20615 Aspiration and injection for treatment of. and Riley N. ) Medicare Nat’l Average ; Work RVU: 3. Results: A total of 9 patients and 11 first CMC joints underwent this operation. I ran these two codes through Optum360 EncoderPro and 3M Coding and Reimbursement System and both have CCI conflicts. 1016/j. 0. 2019 Jan;44(1):64. 02) Metacarpal shaft fracture,. 1 cm to 30. Most injuries are. Interposition arthroplasty, intercarpal or carpometacarpal joints (25447) Revision of arthroplasty, including removal of implant, wrist joint (25449) Arthrodesis, wrist joint (including radiocarpal and/or ulnocarpal fusion); with iliac or other autograft (includes obtaining graft) (25810) Arthrodesis and resection of radioulnar joint (25830)541. 2018 Facility (Hospital / surgi- center, etc. 26842. Use the appropriate CPT code in Item 24D on the CMS-1500 form (or electronic equivalent) and link it to the applicable ICD-9-CM code in Item 24E (or electronic equivalent). 7 Disturbances of salivary secretion R68. the risk/benefit ratio for CMC joint treatment. 69 ± 1. Quick reference tables. For every operated hand, the Kapandji score, key-pinch strength, grip strength and pain on a. sympathetic denervation in patients with resistant hypertension. Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant (P < . The joints are connecting into two spinal vertebrae together as following, Policy. The meaning of DENERVATE is to deprive of a nerve supply. . Selective denervation of the thumb CMC joint is a rarely considered alternative approach that can be used to treat pain associated with CMC arthritis. With the included Guidewire and 4 mm cannulated Drill Bit, the bone. 2 (5. 0 branch at the fifth carpometacarpal (CMC) joint (range, 0–2; Table 1). Within the CMC joint of theSince the resulting chemical denervation of muscle produces local paresis or paralysis, selected muscles can be treated. Type in text to find: Deep Debridement CPT Codes. 11) Metacarpal base fracture, open (815. I am just not sure if I can code for the epidural injection via indwelling catheter the following 2 days. We recommend avoiding transverse incisions in the snuffbox region between 2. jhsa. Treatment with denervation may offer a quicker return to. Basilar Thumb Arthritis. 7-fold increase in the incidence of denervation since 2010 compared to a 2. 1998;2(1):25-35. Western Australian Coding Rule 1110/06 Caudal epidural with epidurolysis Q. Should I be coding under the 64600-64681 or using the unlisted code 64999. Facet Joint Denervation or Radiofrequency Ablation. You don't have many to choose from depending on that was done or using an unlisted code 29999. Metacarpophalangeal dislocation, closed (834. 061 First carpometacarpal (CMC) joint osteoarthritis (OA) is commonly encountered in clinical practice. 5 cm (12044) Layer closure of wounds of neck, hands, feet and/or external genitalia; 12. ICD and CPT Codes for Hand Surgery. All VT episodes occurred in the first 4 months after ablation (2. The first was dorsal, directly proximal to the distal radioulnar joint. 00 - M08. 25% bupivacaine. 0 ± 4. Page 5 of 18 . Google Scholar Kloppenburg M, Kwok WY. 5, 34. Coding and Payment Guide for Medicare Reimbursement: The following are the 2018 Medicare coding and national payment rates for Radio Frequency Ablation (Peripheral Nerves) procedures performed in an ambulatory surgical center, physician office, or outpatient hospital. 0. Other Injections/Aspirations . Results are satisfactory with about. 6 months, pain was reduced from mean of 8. My physician performed an Epidural Lysis and performed three injections over the course of three days. 1 No prior spinal fusion surgery in. 2) Late effect of contusion (nonspecific) (906. Joint denervation, a technique yielding good reproducible results in wrist and. 03) to postoperatively (M = 1. Lateral antebrachial. 549 Ask Dr. Neurectomy of the anterior interosseus nerve. Event marketing. Located at the base of the thumb, the basal joint usually moves quite freely to help position the thumb. Medical Coding. 2022. Carpometacarpal joint denervation is a relatively novel method for managing CMC arthritis, treating the most impactful symptom: pain. Article Guidance. Epub 2017 Apr 25. Mission & Cause Our Mission. 001) reduction in pain scores from baseline (M = 6. Pison C, Shah PL, Slebos D-J, et al. DOI: 10. 43) Crushing injury, wrist (927. Occipital Nerve (CPT Code 64744) for Treatment of Headaches . 008 Corpus ID: 253927867; Denervation of the thumb carpometacarpal joint for symptomatic osteoarthritis in 46 patients. Tech Hand Up Extrem Surg. 4) Excision of neuroma; hand or foot, except digital nerve (64782) The first carpometacarpal (CMC) joint is a frequent location of osteoarthritis in the hand. Neurectomy of the dorsal ulnar sensory nerve articular branches. 67, p < . 02) Metacarpal shaft fracture, closed (815. Bilateral Painful CMC OA No MCP joint hyperextension LEFT SIDE Preoperative Work Up Immediate Post Op –2012 MALE 61 Y. 6. and/or intercarpal and/or carpometacarpal joints) 21. H J Klein , 10. Pen – clicking type; Gloves – non. All VT episodes occurred in the first 4 months after ablation (2. , COOLIEF) • Endoscopic radiofrequency denervation . Suture was then passed thru the hole in base of 2nd metacarpal. #1. Spermatic cord denervation is usually performed under general anesthesia in an operating room. 64636 for non-thermal joint denervation including chemical, low-grade thermal energy (<80 degree Celsius), or any form of pulsed radiofrequency. N/A. The complications of primary surgery, although relatively rare, can present in various clinical ways. Remember Me. 1. It runs from the scaphoid and trapezium carpal bones, and from the flexor retinaculum to the proximal phalanx of thumb. Lower extremity sensory and mixed nerves A. 2-fold increase in the incidence of non-denervation CMC OA surgery over that same time (Figure 1B). Results Of 169 references, 17 articles reporting on 384 denervations in 351 patients were selected. At mean 125. 1 _, if it is Primary (Degenerative) Osteoarthritis, and unilateral. 8 First described in 1991, thumb CMC denervation has reported success rates in the literature ranging from 35% to 87% in patients with symptomatic osteoarthritis. 30465956. e. The Coding Information section has been revised to add a guideline for CPT code 72275. Results: Denervation was safe, with less downtime than trapeziectomy with ligament reconstruction with tendon interposition and provided durable complete or partial relief of pain after 5 years in 5 of 9. Criteria. 2 percent of men with this problem. We do this by removing a small wrist (carpal) bone called the trapezium, and the bone spurs. Note: Report CPT code 64999 when facet cyst aspiration/rupture. Non-thermal facet joint denervation (including chemical, low grade thermal energy [<80 degrees Celsius] or any other form of pulsed radiofrequency) should not be reported with CPT codes 64633, 64634, 64635 or 64636. doi: 10. You may develop scar tenderness. 8 months, range = 3-90 months). wneu. CPT® code 64611; HCPCS codes J0587, J0585, J0588 Group 3 Codes: (2 Codes) CODE DESCRIPTION K11. CPT code 46505; HCPCS codes J0585, J0586, J0587, J0588 Group 1 Codes: Group 2 Paragraph: CPT Code 52287; HCPCS code J0585 Group 2 Codes: Printed on 8/8/2018. 0 “primary arthrosis of first carpometacarpal joint, bilateral “ M18. 11) Metacarpal base fracture, open (815.