CPT code 64636 is an add-on code for image-guided neurolytic destruction of a lumbar or sacral facet joint nerve at an additional level beyond an initial, separately reported facet joint neurolytic injection. The procedure uses heat, electrical current, or chemical agents and requires imaging guidance such as fluoroscopy or CT. This code matters nationally because lumbar and sacral facet denervation procedures are common components of interventional pain management for axial back pain, and accurate coding affects procedure reporting, payment bundling, and utilization monitoring.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical intent of the code, typical sites of service, common modifiers listed with the code, and national policy considerations affecting add-on reporting and imaging guidance. The publication also summarizes expected billing context — that 64636 is used only when an additional facet level is treated after a separately reportable initial level — and highlights areas where payers commonly apply medical necessity reviews or documentation requirements.

This summary guides clinicians, coding professionals, and policy analysts through the essential clinical and billing characteristics of CPT code 64636, clarifying when the add-on code is reported and what operational settings typically deliver the service. Data not available in the input will be noted in relevant sections.