CPT® Code 64634

Add-On Code

Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)

Paravertebral facet joints, also known as zygapophyseal joints, are located on the posterior aspect of the spine, situated on each side of the vertebra where one vertebra overlaps the next. The procedure described by CPT® Code 64634 involves the destruction of the paravertebral facet joint nerve(s) using a neurolytic agent, which is guided by imaging techniques such as fluoroscopy or computed tomography (CT). This procedure is specifically indicated for the cervical or thoracic regions of the spine and is performed for each additional facet joint beyond the primary procedure. The use of a neurolytic agent, which can include substances like phenol, ethyl alcohol, glycerol, ammonium salt compounds, and hypertonic or hypotonic solutions, aims to alleviate pain by disrupting the nerve pathways associated with the facet joints. The procedure is performed under local anesthesia, ensuring patient comfort while allowing for precise targeting of the nerve tissue. The imaging guidance is crucial for accurately positioning the needle and ensuring the effectiveness of the neurolysis, thereby enhancing the overall outcome of the treatment.