SAN DIEGO — Reimbursement for pulsed radiofrequency, an experimental treatment for some types of chronic pain, now requires the use of unlisted procedure code 64999, as designated by the American Medical Association's Current Procedural Terminology (CPT).
The designation follows extended debate over a proposal by the North American Spine Society to assign pulsed radiofrequency to category 3 in the CPT section on emerging technology, said Dr. Eduardo M. Fraifeld, chairman of the Coding and Reimbursement Committee of the American Academy of Pain Medicine (AAPM).
“When seeking reimbursement for pulsed radiofrequency, it is incorrect to use codes for radiofrequency ablation, including 64626 and 64627, which are neurolytic codes,” Dr. Fraifeld explained at the annual meeting of the AAPM.
In another pain-therapy CPT code overhaul, the AAPM's Coding and Reimbursement Committee eliminated the “Sedation With or Without Analgesia (Conscious Sedation)” category (99141–42) and replaced it with “Moderate (Conscious) Sedation.” The new category has three codes for drug administration by the same physician performing the diagnostic or therapeutic service (99143–45) and three codes requiring an additional independent observer to monitor the patient (99148–50). These two categories are then broken down into three subcategories, which include under age 5 first 30 minutes intraservice time, age 5 and older first 30 minutes intraservice time, and an add-on code for each additional 15 minutes intraservice time, Dr. Fraifeld said.
Other deletions this year include eight evaluation and management codes for “Follow-up Inpatient Consultations” (99261–3) and “Confirmatory Consultations” (99271–5).