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January 31, 2022 - Updated March 10, 2022

Billing and Coding Instructions: Cryoneurolysis

Cryoneurolysis a medical treatment which has been proposed to be a mechanism for relieving pain by freezing the affected peripheral nerves.

One manufacture of this system, Iovera, instructs providers on their website to bill the treatment with Current Procedural Terminology (CPT) code 64640 (Destruction by neurolytic agent; other peripheral nerve or branch).Code 64640 requires the destruction of target nerve. The Iovera system is temporary and not destructive. Therefore, CPT code 64640 is not appropriate for Medicare billing.

While there is no specific CPT code for cryoneurolysis, CGS has determined the most appropriate codes for this technology is represented by codes 0440T, 0441T and 0442T, until a permanent CPT code is provided.

  • 0440T - Ablation, percutaneous, cryoablation, including image guidance; upper extremity distal/peripheral nerve
  • 0441T - Ablation, percutaneous, cryoablation, including image guidance; lower extremity distal/peripheral nerve
  • 0442T - Ablation, percutaneous, cryoablation, including image guidance; nerve plexus or truncal nerve (eg. Brachial plexus, pudendal nerve)

Use 0441T for the Iovera system for use in the knee.

Note: CGS may request additional documentation and review on case-to-case basis for medical necessity.


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