Summary & Overview
HCPCS C9752: Basivertebral Nerve Destruction, Lumbar/Sacrum
HCPCS Level II code C9752 denotes destruction of the intraosseous basivertebral nerve for the first two vertebral bodies, including imaging guidance, in the lumbar/sacrum region. This code captures a specialized neurodestructive procedure used to treat vertebrogenic low back pain and is becoming more relevant as minimally invasive spine interventions expand nationally. Payers commonly evaluate coverage and reimbursement for this procedure based on clinical indication, prior authorization criteria, and evidence of durable pain relief.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical intent and service setting, an outline of typical payer considerations, and benchmarking context where available. The publication summarizes common billing modifiers and payer policy themes, highlights coding clarity around imaging guidance inclusion, and identifies gaps where payer-specific coverage criteria or outcome evidence are not present.
This briefing is intended to inform billing professionals, policy analysts, and clinical managers about the code’s purpose, expected site-of-service, and what to look for in payer policy documentation and claims adjudication.
Billing Code Overview
HCPCS Level II code C9752 describes the destruction of the intraosseous basivertebral nerve for the first two vertebral bodies, performed with imaging guidance (for example, fluoroscopy) in the lumbar/sacrum region. This procedure targets the basivertebral nerve within vertebral bodies to address vertebrogenic low back pain.
Service type: Nerve ablation / neurodestruction procedure
Typical site of service: Hospital outpatient department or ambulatory surgical center, with image guidance provided during the procedure.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 40–70 year-old adult with chronic axial low back pain refractory to conservative therapy (physical therapy, medications, epidural injections) for at least 6 months. The patient has focal vertebrogenic pain localized to the lumbar spine with positive diagnostic testing (e.g., concordant pain on targeted provocation or positive imaging such as Modic type 1 changes on MRI) and has undergone evaluation by a spine specialist (physiatrist, interventional pain physician, or spine surgeon). After shared decision-making, the patient is scheduled for a procedure to perform thermal or radiofrequency ablation/destruction of the intraosseous basivertebral nerve at the first two lumbar vertebral bodies involved, performed in an interventional suite.
Pre-procedure workflow includes history and physical, review of imaging, informed consent, medication reconciliation including anticoagulation management, and appropriate pre-op testing. On the day of service the patient is positioned prone; local anesthesia and conscious sedation or monitored anesthesia care are administered. Under continuous imaging guidance (e.g., fluoroscopy), a transpedicular or intravertebral approach is used to access the basivertebral nerve within the vertebral body, and energy is applied to thermally ablate the nerve. Post-procedure, the patient is observed for recovery, given discharge instructions for activity and pain control, and scheduled for follow-up to assess pain relief and any complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |