6 months, pain was reduced from mean of 8. and Riley N. 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. These patients who underwent secondary LRTI after denervation reported their recurrence of pain at 16. 2017 Jun;36(3):192-197. What are the risks of CMC ligament repair? You may bleed more than expected or get an infection. Best answers. Hardware CPT Codes. CPT Knowledgebase - Oct 26, 2017 When a physician performs a right first carpometacarpal joint injection without ultrasound guidance, is it appropriate to report code 20605 for an intermediate joint injection (eg, wrist), or is it appropriate to report code 20600 for a small joint injection? Login. Occipital Nerve (CPT Code 64744) for Treatment of Headaches . My physician performed an. 4) per month after ablation. Documentation, Utilization and ICD-10-CM coding sections have been added. 7 and postoperative Quick Dash improved to 17. Superficial radial nerve. " D. Apr 7, 2021. It can be of particular benefit in. Partial denervation can be performed with one or two incisions and typically involves transection of the posterior and anterior interosseous nerves. Undoubtedly, denervation of the first carpometacarpal (CMC-1) joint represents a promising treatment alternative for patients suffering from CMC-1-joint osteoarthritis, resistant to conservative. 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. 7 to 0. Access the full ICD-10 Coding Guide for $9. N/A. Bilateral Painful CMC OA No MCP joint hyperextension LEFT SIDE Preoperative Work Up Immediate Post Op –2012 MALE 61 Y. Creation of Uniform LCDs Within a MAC Jurisdiction; Revisions Due To CPT/HCPCS Code Changes; 01/01/2017 R7 LCD revised and published on 01/12/2017. 1016/j. Remember Me. Some authors have described the nerve branches of thumb CMC joint. 01) Metacarpal base fracture, closed (815. Suture was tied over the bridge between the 2 smaller holes. Between October 2005 and August. Pen – clicking type; Gloves – non. 008 Corpus ID: 253927867; Denervation of the thumb carpometacarpal joint for symptomatic osteoarthritis in 46 patients. 04)M18. The first was dorsal, directly proximal to the distal radioulnar joint. We would like to show you a description here but the site won’t allow us. Low complexity – 15 minutes: 99213. It is concluded that volar CMC joint denervation is a useful procedure, preserving joint function and relieving pain long-term. Increase in palmar ABD by 30% at the final visit. Introduction Osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint is a common disorder that negatively impacts hand function. Selective denervation of the thumb carpometacarpal (CMC) joint is a viable approach to treat pain and disability associated with CMC arthritis, with less morbidity and faster. Debridement CPT Codes. ICD-10 Codes Description K11. CPT code 64625 has been added to CPT/HCPC Codes Group 2 effective for dates of service on or after 01/01/2020. 1. e. 9% $2,003 $2,142 6. 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. It pierces the deep fascia of the forearm approximately 7 cm proximal to the radiocarpal joint (9 cm proximal to radial styloid) runs over snuff box to supply dorsal radial surface of hand. 2) Late effect of contusion (nonspecific) (906. interosseous nerve. 27). You don't have many to choose from depending on that was done or using an unlisted code 29999. 0) during the month before ablation to 0. 6) Late effect of sprain/strain (nonspecific) (905. Jan 25, 2017. 007. Background: Pain reduction as well as preservation and improvement in range of motion remain the main aims in the treatment of thumb carpometacarpal (CMC) osteoarthritis (OA). The posterior interosseous has its roots in the cervical spine (C6, C7, C8) and arises as a branch from the radial nerve. org The Best Resource For Your Hands, Period. High complexity – 40 minutes: 99215. When nonoperative management fails, surgery may be indicated. 9, 10, 11 Cadaveric. Answer: The carpometacarpal joint is considered a small joint, therefore, it is appropriate to report code 20600, Athrocentesis, aspiration, and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance, for this procedure. Should I be coding under the 64600-64681 or using the unlisted code 64999. 54 “pain in a joint, hand” CPT code: 20600 “Arthrocentesis, aspiration and/or injection; small joint or bursa (eg, fingers, toes)” Materials Needed. the hemitrapeziectomy is an arthrodesis of the 1st CMC which my. 2011;8:22–31. [2] were disappointed by thumb CMC denervation, observing that only 35% of their patients had more than 70% pain relief. Hypertension (HTN) affects approximately 50% of the adult population and is one of the most important contributors to cardiovascular morbidity and mortality. Arthrodesis Procedures on the Hand and Fingers. All patients demonstrated improved grip strength at diagnostic injection. Phase 3: Studies that gather more information about safety. 4 million people in the UK have osteoarthritis of the hand, requiring two million primary care consultations per annum. Heart Rhythm 11(3): 360-366. 95 post op (P<0. Jul 21, 2011. It is. Surgical denervation of the thumb carpometacarpal (CMC) joint is a theoretical surgical option for thumb CMC arthritis. 007. 25446 . Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Clinical Outcomes and Cadaveric Study J Hand Surg Am . Wrist Pain - Denervation Codes. the hemitrapeziectomy is an arthrodesis of the 1st CMC. 116 Facet Joint Denervation Effective Policy Date: April 1, 2020 Original Policy Date: June 2012 Related Policies: 7. Results Carpometacarpal CMCjoints American Academy of Professional Coders – – TMC (Thumb) Session 1A, 10-11:30 AM Friday, October 26th, 2012 Hand Dissection Skin Palmar Fascia Subcutaneous tissues Bursa Pulleys/Sheaths Neurovascular bundles American Academy of Professional Coders Session 1A, 10-11:30 AM Friday, October 26th, 2012 Pain in joint, forearm (719. 12 Recent attention has been placed on the role of CMC denervation in the treatment of CMC arthritis. Patients who had denervation were 49% male compared to 24% male in the non-denervation group and were of similar ages 63±8 vs 62±8 years in the denervation. Medical conditions that can affect the thenar eminence include carpal tunnel syndrome, arthritis, and amyotrophic lateral sclerosis (ALS), among others. 4 Idiopathic orofacial. The insurance company is denying the 64627 stating this is an. 04 _) is rare by comparison, though it. 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. Answer CPT 25447 vs 25820 - Interposition Flap Arthroplasty of Radiocarpal. Neurectomy of the dorsal radial sensory nerve articular branches. Please refer to the Local Coverage Article: Billing and Coding: Facet Joint Interventions for Pain Management (A58405). 2019 Jun;238:144-151. 02) Metacarpal shaft fracture, closed (815. 0001). Exploration of penetrating extremity wound separate procedure (20103) Superficial Debridement. The procedure can take 2 to 3 hours to perform. Sacroiliac (SI) Joint Nerve Denervation (CPT Code 64625) Medicare does not have a National Coverage Determination (NCD) for SI nerve denervation. 11) Metacarpal base fracture, open (815. This service is reported as 29868 – Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral. The complications of primary surgery, although relatively rare, can present in various clinical ways. I have found a couple of payer policies that state to bill an endoscopic rhizotomy with CPT code 64999 or they deem it experimental all together. 5 months in the arthroplasty group). 08/01/2019 R4 The title of the article has been revised to add Billing and Coding. 2022. Foucher was convinced that. 0000000000000057. Selective denervation has been successfully employed to treat arthritis pain in a number of joints throughout the body. 6 months, pain was reduced from mean of 8. 6) Late effect of sprain/strain (nonspecific) (905. 011. Best answers. 4. All diagnosis coding was converted from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) on October 1, 2015. 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. We present the innervation of the thumb CMC joint (thenar - recurrent - branch of median nerve, palmar branch of. 43) Crushing injury, wrist (927. 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. 33-)Denervation of the wrist may be a good alternative in patients who are not candidates for these procedures or who cannot afford to lose motion or spare the time to recuperate from larger surgical interventions. Description of Procedure or Service Facet joint denervation is performed under local anesthetic and with fluoroscopic guidance. • Cooled radiofrequency ablation for facet denervation (e. Selective denervation of the thumb CMC joint is a rarely considered alternative approach that can be used to treat pain associated with CMC arthritis. We recommend avoiding transverse incisions in the snuffbox region between 2. 2 percent of men with this problem. Facet Joint Denervation: The thermal radiofrequency destruction of cervical, thoracic, or lumbar paravertebral facet joint (medial branch). Before undergoing surgical CMC denervation, patients received a joint block at the first CMC joint with 0. 10. 9% Coronary PCI Drug Eluting Stents (including FFR/OCT) DES, with. These services should be reported with CPT code 64999. 2018 Facility (Hospital / surgi- center, etc. 13 CMC denervation identifies and transects the nerves serving the CMC joint, thereby providing pain relief. Description of Procedure or Service Facet joint denervation is performed under local anesthetic and with fluoroscopic guidance. jhsa. Arthroplasty with prosthetic replacement, trapezium (25445) Interposition arthroplasty, intercarpal or carpometacarpal joints (25447) Partial Trapezoid excision. The number of VT episodes was decreased from 11. We read with great interest the recent systematic review by Teo I. 01) Metacarpal base fracture, closed (815. ) Medicare Nat’l Average ; Work RVU: 3. and/or intercarpal and/or carpometacarpal joints) 21. Facet Joint Injection. Renal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension. 2,3 The impact of thumb CMC arthritis on U. 2 branch at the ulnocarpal joint (range, 0–2) and 1. 08/01/2019 R4 The title of the article has been revised to add Billing and Coding. 03) Thumb base metacarpal fracture, open (815. Phase 3: Studies that gather more information about safety. Question ID : 12304. 0. 67, p < . or depending on the insurance plan use 25210 x (times) # of bones, up to 4. We performed a retrospective outcome analysis of patients with symptomatic stage II-III thumb CMC joint arthritis treated with denervation, joint lavage and capsular imbrication. 5 months). This study reviewed literature on CMC denervation for first CMC arthritis. 8 months, range = 3-90 months). Thumb carpometacarpal joint (CMCJ) osteoarthritis (OA) is a common problem affecting 7% of men and 15% of women. The preferred surgical option when. Early-stage arthritis is often amenable to nonsurgical treatment with an orthosis and steroid injections. Prospective studies with validated patient-reported and objective outcome measures between distinct treatment arms, such as denervation versus ligament. Carpometacarpal Joints /. 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. FEP 7. 2) Late effect of. We do this by removing a small wrist (carpal) bone called the trapezium, and the bone spurs. 2) Late effect of contusion (nonspecific) (906. hansur. Straightforward – 10 minutes: 99212. Suture was then passed thru the hole in base of 2nd metacarpal. CPT code 20551 should be used when the origin or insertion of a tendon is injected, in contrast to an injection of the tendon sheath, CPT code 20550. I am hesitant, would this approach my provider is describing qualify as MIS as he states his approach is. CPT® Code Short Descriptor MD In-Office Medicare Allowed Amount MD In-Facility Medicare Allowed Amount Total Office-Based RVUs Total Facility-Based RVUs Pelvic Floor Repair Procedures - Capio™ Slim for Native Tissue Repair or Biologic Graft 57240 Anterior repair, cystocele N/A $613 N/A 17. Mahfoud F, Cremers B, Janker J et al. Nine studies were identified with 184 denervation procedures undertaken in 175 patients. In preparation for the transition from ICD-9 to ICD-10 medical coding on . clinical literature on CMC denervation for CMC OA. Each of three patients, two of whom were musicians, returned to full professional ability. Carpometacarpal joint denervation is a relatively novel method for managing CMC arthritis, treating the most impactful symptom: pain. Finger wounds Codes. 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. With the introduction of novel methods, new technologies and amended trial designs, it is now rising like a phoenix out of the ashes. ICD-10 Codes Description K11. Foucher et al. Objective. Pain, strength, range of motion, DASH. Documentation Requirements. 04 closed or 833. Modifier 50 is not appropriate because coding is based on the number of muscles treated. My surgeons are starting to perform AIN to Ulnar nerve transfer more often and we are trying to determine the most appropriate coding. Within the CMC joint of theSince the resulting chemical denervation of muscle produces local paresis or paralysis, selected muscles can be treated. The corresponding medical conditions for which Botulinum toxins are used should be listed with the respective CPT code. 0. However, the innervation pattern of the thumb CMC joint is controversial. If denervation is performed bilaterally, Modifier 50 should be appended to the procedure code with number of services of one. Injections for other tendon origin/insertions. Need help with CPT and modifiers for the following scenario: Denervation of branches using transection from: 1. Denervation for CMC osteoarthritis was first described by Cozzi in 1991 [21] in a book chapter, with “good” results in 87% of patients, but no further description of data acquisition and interpretation. Injections for plantar fasciitis are addressed by 20550 and ICD-10-CM M72. 1. 7 Disturbances of salivary secretion R68. This article was converted to the new Billing and Coding Article type. 11) Metacarpal base fracture, open (815. 3. Wrist Pain - Denervation Codes. Average follow-up of patients was 26. This technique has been shown to provide pain relief with minimal complications and a quickSacroiliac (SI) Joint Nerve Denervation (CPT Code 64625) Medicare does not have a National Coverage Determination (NCD) for SI nerve denervation. In the middle third of the forearm, it lies behind the same muscle, close to the lateral side of the artery. Our doc did an excision of verruca vulgaris and wants to bill CPT 26160 which I know is completely wrong, but Im confused whether to use an excision of a soft mass or CPT 17xxx? Elliptical incision was made surrounding the mass, which was carefully dissected beneath the. 001) reduction in pain scores from baseline (M = 6. 2 (5. 3. The splint is only removed when washing or doing post-operative wrist exercises. Pain relief is variable and gradual over 18 months. These services should be reported with CPT code 64999. Note: Report CPT code 64999 when facet cyst aspiration/rupture. Other Injections/Aspirations . Three patients underwent eventual CMC arthroplasty with LRTI at 17. Note: Report CPT code 64999 when facet cyst aspiration/rupture. Aug 10, 2011. 1998;2(1):25-35. Common examples of unbundling and miscoding errors include: Reporting a ganglion cyst excision (25111 Excision of ganglion, wrist (dorsal or volar); primary) in addition to a synovectomy of the wrist. 01. Epub 2019 Feb 13. A review of four cases. 1 _, if it is Primary (Degenerative) Osteoarthritis, and unilateral. Our Cause. We present the innervation of the thumb CMC joint (thenar - recurrent - branch of median nerve, palmar branch of median nerve, superficial branch of. Spermatic cord denervation is usually performed under general anesthesia in an operating room. These services should be reported with CPT code 64999. Hand osteoarthritis—a heterogeneous disorder. 9. jhsa. The first carpometacarpal (CMC) joint is a frequent location of osteoarthritis in the hand. Contusion Sprain / Strain / Ligament Injuries ICD9 Codes Thumb base metacarpal fracture, closed (815. Two investigators independently identified studies that reported on denervation for OA of the proximal interphalangeal, distal. Carpometacarpal dislocations. 14,16,19 This group had a combined sample size of 80 patients (61 women and 19 men) and. The vast array of available surgical techniques includes excisional arthroplasty, limited and total fusion, total wrist denervation, partial and total arthroplasty, as well as rib-cartilage graft implantation. Patients who had denervation were 49% male compared to 24% male in the non-denervation group and were of similar ages 63±8 vs 62±8 years in the denervation. e8. Wrist arthrodesis, also known as wrist fusion, is a procedure in which the wrist joint is immobilized by fusing the radius to the carpal bones. 5: DBUN. Undoubtedly,. I have a provider that is doing a Radiofrequency Ablation right Cervical Facet Joint medical branch nerves; C2, C3, C4, C5, C6, and 3rd occipital nerve. 3 months for no denervation group (p = 0. There was 3. In an Ambulatory Surgical. All VT episodes occurred in the first 4 months after ablation (2. Password Forgot my Password. 01. Denervation procedures have been shown to be a valid option in other joints: e. 21) Late effect of sprain/strain (nonspecific) (905. cclarson Guru. 00 - M08. 052. Long-term follow-up after ligament reconstruction with tendon interposition. 2 to 4 weeks: The cast and stitches are removed, and you'll be given a plastic splint to stabilize the wrist. Carpal bone dislocations: an analysis of twenty cases with relative emphasis on the role of crushing mechanisms. The procedure can take 2 to 3 hours to perform. The Coding Information section has been revised to add a guideline for CPT code 72275. 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. Typically, patients have pain in the base of the thumb and with the progression of the disease: atrophy of thenar muscles, subluxation of the first carpometacarpal joint, loss of pinch and grip. 69 ± 1. Best answers. Among the 6 patients who had previously undergone spinal surgery, 2 (33. [1]Abductor pollicis brevis is the most lateral and the most superficial of thenar muscles, located underneath the skin. 61 ± 2. The clinical outcomes were more effective in the early-stage group (Eaton stages I and II. Patient satisfaction was higher in the denervation group. PROCEDURE: An incision was made over the radial edge of the flexor pronator mass just distal to the elbow flexion crease. You can bill for the use of the microscope if used, 69990. 03) Thumb base metacarpal fracture, open (815. Spine J 2008; 8(3):498-504. NCT03558204. Radiofrequency Facet Denervation (also known as non-pulsed radiofrequency denervation, facet neurotomy, facet rhizotomy, or articular rhizolysis) of cervical facet joints (C2-C3 thru C7-T1 vertebrae) and lumbar facet joints (T12-L1 thru L5-S1 vertebrae) may. 0 “primary arthrosis of first carpometacarpal joint, bilateral “ M18. Arthroplasty of the basal joint of the thumb. Both procedures demonstrated durable improvement in bMHQ compared with the preoperative state with similar long-term outcomes over 2 years of. 0. Other patients may be better served with a vasectomy reversal, conversion to an open-ended vasectomy, excision of a sperm granuloma, or epididymectomy. At mean 125. Keywords: Denervation, CMC, joint. Fenig performs to treat this pain. 7 to 0. 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. S. Feragamo. HCPCS code V2790 (amniotic membrane for surgical reconstruction, per procedure) is included in the allowance for CPT Codes 65778 and 65779. The Clarksville-Montgomery County Education Foundation exists to support the improvement of public education by providing the Clarksville-Montgomery County School System additional funding for the support of programs and initiatives that contribute to student achievement. Dissection was down through skin and subcutaneous tissue, protecting any nerves and arteries, and the small branching vessels were cauterized. Complete wrist denervation through a dorsal approach including neurectomy of the posterior. 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. 6 cm to 20. CPT 2018 Appendix J—Electrodiagnostic Medicine Listing of Sensory, Motor, and Mixed Nerves Appendix J = Revised code •=New code cb=Contains new or revised text H=Modifier 51 exempt American Medical Association 795 II. 4) per month after ablation. 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. The VAS pain score decreased from an average of 7. 2. Giesen T, Klein HJ, Franchi A, Medina JA, Elliot D. Injury & Clinical Conditions. 04) M18. You may develop scar tenderness. wneu. Results are listed in Table 1. 02) Metacarpal shaft fracture, closed (815. Reg Anesth Pain Med 2007; 32(6):495-503. hansur. CPT Codes. Mission & Cause Our Mission. In all studies, joint denervation improved pain and hand function at follow-up (M = 36. Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans. Between 2006 and 2018, 46 patients underwent the procedure in our clinic and were included in this retrospective study. 1016/j. An anatomic spinal region for thermal facet joint denervation is defined as cervical/thoracic (CPT codes 64633 and 64634) or lumbar/sacral (CPT codes 64635 and 64636) per the AMA CPT Manual. 7-fold increase in the incidence of denervation since 2010 compared to a 2. 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. jhsa. Prospective. jhsa. The procedure is well tolerated, with faster recovery as compared with trapeziectomy. Lateral pinch improved 25% at post-op and 29% by the final visit. 2018. The chart below identifies which trade name. 69 ± 1. Palmar cutaneous branch of median nerve. The Hand Center at Flagstaff Bone and Joint is located at 77 W Forest Ave. CPT Codes. MCP Joint Dislocation / Ligament Injury CPT Codes. Since the resulting chemical denervation of muscle produces local paresis or paralysis, selected muscles can be treated. Orthopaedics. e. Procedure: Denervation of the thumb CMC joint; Procedure: trapeziectomy with ligament reconstruction (LRTI) Detailed Description. Society. 001) reduction in pain scores from baseline (M = 6. Three studies reported changes in pain following denervation of the CMC joint using the VAS or NRS score. Diagnosis is made clinically with a painful CMC grind test and radiographs of the hand showing osteoarthritis of the 1st CMC joint. 0) during the month before ablation to 0. 2018. 25449 . 21) Late effect of sprain/strain (nonspecific) (905. 7. 2 [6, 8, 23,24,25,26,27]. 1 Complete wrist denervation alleviates chronic wrist pain by approximately 67% in patients with degenerative arthritis. In5 to 10 days: You will have a follow-up appointment with your surgeon. 8 (range of 10-20 sessions) Pre to post-op grip strength had 50% improvement. Optum states "Code 25825 (column 1) has a CCI conflict with code 25210. Joint denervation, a technique yielding good reproducible results in wrist and. 12) Carpometacarpal dislocation, closed (833. Username Forgot my Username. 008 Corpus ID: 253927867; Denervation of the thumb carpometacarpal joint for symptomatic osteoarthritis in 46 patients. 1 “primary arthrosis of first carpometacarpal joint, unilateral “ M25. Results Cadaveric dissections- Nerve branches to the thumb CMC joint were found to arise from the lateral antebrachial cutaneous nerve (9/9 cadavers; 100%), the palmar cutaneous branch of the median nerve (6/9. All patients who underwent first CMC joint denervation surgery from January 2015 through September 2017 were retrospectively identified. 9% Renal denervation, bilateral 5192 0339T $4,679 $4,953 5. Late effect, arm fracture (nonspecific) (905. 007. There was 3. Percutaneous skeletal fixation of metacarpal fracture, each bone (26608) Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation (26706)W/larger drill bit a hole made in the base of thumb metacarpal. Good morning! We've had a little back and forth going on in my office regarding a patient's surgery. Neurectomy of the dorsal ulnar sensory nerve articular branches. It is concluded that volar CMC joint denervation is a useful procedure, preserving joint function and relieving pain long-term. I agree with 20600 for the CMC injection code. 6 ± 1. Terminal branches. Results Of 169 references, 17 articles reporting on 384 denervations in 351 patients were selected. 03) Thumb base metacarpal fracture, open (815. 03. If denervation is performed bilaterally, Modifier 50 should be appended to the procedure code with number of services of one. For additional information or to schedule an appointment, visit or call 928-773-2280. It looks like CPT code 62263 is the correct code for the percutaneous epidural adhesion. 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. A review of four cases. dcepeda New. 6 to 8 weeks: The splint can now be worn at night. 25% bupivacaine. and Riley N. 26841.