Interventional Pain Medicine in the ASC and Outpatient Setting
Interventional pain medicine physicians, many of them internists by training, treat chronic spine and joint pain with image-guided injections and ablation procedures, often in an ASC with same-day discharge. In our dataset this specialty maps to 318 ASC-relevant CPT codes, most in the pain procedure range 62320 to 64999, such as 64483 (a single-level lumbar or sacral transforaminal epidural injection) and 64635 (destruction of a lumbar or sacral facet joint nerve).
For ASC work, what matters is whether a code sits on CMS Addendum AA, the ASC Covered Procedures List that Medicare will pay in an ASC, versus Addendum EE, which excludes it. Knowing where each pain code lands, and the prior-authorization and documentation rules attached to it, is the difference between a clean claim and a denial.
Internal Medicine – Pain Medicine codes(1–60 of 318)
- 64483Njx aa&/strd tfrm epi l/s 1
- 64635Destroy lumb/sac facet jnt
- 64493Inj paravert f jnt l/s 1 lev
- 62320Njx interlaminar crv/thrc
- 62321Njx interlaminar crv/thrc
- 62322Njx interlaminar lmbr/sac
- 62323Njx interlaminar lmbr/sac
- 62324Njx interlaminar crv/thrc
- 62325Njx interlaminar crv/thrc
- 62326Njx interlaminar lmbr/sac
- 62327Njx interlaminar lmbr/sac
- 62328Dx lmbr spi pnxr w/fluor/ct
- 62329Ther spi pnxr csf fluor/ct
- 62330Dcmprn prq rmv lig flv 1lmbr
- 62331Dcmprn prq rmv lig flv addl
- 62350Implant spinal canal cath
- 62351Implant spinal canal cath
- 62355Remove spinal canal catheter
- 62360Insert spine infusion device
- 62361Implant spine infusion pump
- 62362Implant spine infusion pump
- 62365Remove spine infusion device
- 62367Analyze spine infus pump
- 62368Analyze sp inf pump w/reprog
- 62369Anal sp inf pmp w/reprg&fill
- 62370Anl sp inf pmp w/mdreprg&fil
- 62380Ndsc dcmprn 1 ntrspc lumbar
- 63001Remove spine lamina 1/2 crvl
- 63003Remove spine lamina 1/2 thrc
- 63005Remove spine lamina 1/2 lmbr
- 63011Remove spine lamina 1/2 scrl
- 63012Remove lamina/facets lumbar
- 63015Remove spine lamina >2 crvcl
- 63016Remove spine lamina >2 thrc
- 63017Remove spine lamina >2 lmbr
- 63020Lamot dcmprn nrv rt 1 cerv
- 63030Lamot dcmprn nrv rt 1 lmbr
- 63035Lamot dcmprn nrv rt ea addl
- 63040Laminotomy single cervical
- 63042Laminotomy single lumbar
- 63043Laminotomy addl cervical
- 63044Laminotomy addl lumbar
- 63045Lam facetec & foramot crv
- 63046Lam facetec & foramot thrc
- 63047Lam facetec & foramot lumbar
- 63048Lam facetec &foramot ea addl
- 63050Cervical laminoplsty 2/> seg
- 63051C-laminoplasty w/graft/plate
- 63055Decompress spinal cord thrc
- 63056Decompress spinal cord lmbr
- 63057Decompress spine cord add-on
- 63064Decompress spinal cord thrc
- 63066Decompress spine cord add-on
- 63075Neck spine disk surgery
- 63076Neck spine disk surgery
- 63077Spine disk surgery thorax
- 63078Spine disk surgery thorax
- 63081Remove vert body dcmprn crvl
- 63082Remove vertebral body add-on
- 63085Remove vert body dcmprn thrc
Are pain management procedures performed in an ambulatory surgery center?
Yes, many are. Image-guided injections and radiofrequency ablation are commonly done in ASCs and office-based labs because they are short, same-day procedures. Whether Medicare pays a specific code in an ASC depends on its CMS addendum status. Codes on Addendum AA are on the ASC Covered Procedures List and are payable in an ASC, while codes on Addendum EE are excluded from ASC payment. Some pain procedures are also routinely performed in the office under place of service 11.
What CPT codes does interventional pain medicine use?
Most fall in the pain procedure range 62320 to 64999. Common families include interlaminar epidural injections such as 62320, transforaminal epidural injections such as 64483, paravertebral facet joint injections such as 64493, and facet joint nerve destruction by radiofrequency ablation such as 64635. The exact code depends on the spinal region treated, the number of levels, and whether the service is diagnostic or therapeutic.
What is the difference between a facet joint injection and radiofrequency ablation in billing terms?
A facet joint injection, such as 64493 in the lumbar or sacral region, places medication in or around the joint and is often used both diagnostically and therapeutically. Radiofrequency ablation, such as 64635, destroys the nerve that supplies the joint to provide longer lasting relief. They are separate code families with their own level-based add-on codes, and payers frequently require documentation of prior diagnostic blocks before approving ablation.