CPT® Code 64622

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The procedure described by CPT® Code 64622 involves the destruction of the paravertebral facet joint nerve located in the lumbar or sacral region of the spine. Paravertebral facet joints, also known as zygapophyseal joints, are situated on the posterior aspect of the spine, where adjacent vertebrae overlap. This procedure is typically performed to alleviate pain associated with conditions affecting these joints. The technique utilizes a neurolytic agent, which is a chemical substance that destroys nerve tissue, thereby interrupting pain transmission. The procedure is conducted under fluoroscopic guidance, which allows for precise visualization of the anatomy and accurate placement of the needle. Prior to the injection of the neurolytic agent, the skin over the facet joint is prepared, and a local anesthetic is administered to minimize discomfort. The use of a spinal needle enables the physician to access the facet joint space, where contrast material may be injected to confirm proper needle placement. Following this, the neurolytic agent is injected along the nerve pathway to achieve the desired therapeutic effect. Various neurolytic agents can be employed, including phenol, ethyl alcohol, glycerol, ammonium salt compounds, and hypertonic or hypotonic solutions. Additionally, thermal or electrical modalities may be utilized, where a probe or electrode is inserted to generate heat that destroys the nerve tissue. This comprehensive approach aims to provide significant pain relief for patients suffering from facet joint-related conditions.