Question:
Ganglion impar injections we have billed under CPT 64999 are being denied. Could you please provide the specific billing guidelines or a recommended comparison code required to process this unlisted procedure successfully?
Answer:
Thank you for your question regarding a comparable code for 64999 when performing a Ganglion impar injection. The Ganglion impar is located at the end of the paravertebral sympathetic nerve chain which runs from the base of the skull to the coccyx. Because there is no CPT code that specifically describes a ganglion impar injection CPT 64999, Unlisted procedure, nervous system would be appropriate.
When selecting a comparison code for reimbursement purposes, CPT 64517, Injection, anesthetic agent; superior hypogastric plexus should be considered because it targets the sympathetic pain pathway in the pelvis. Another potential comparison code is CPT 64520, Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic). The most appropriate comparison code may vary based on the specific technique performed and payer requirements.
*This response is based on the best information available as of 11/12/26.
