By Chris Faubel, MD –
The ganglion impar is a group of sympathetic ganglia which are located anterior to the sacrococcygeal junction; it carries nociceptive signals from the perineum area.
Coccydynia is pain in the area of coccyx, and is seen frequently in patients with a history of falling directly on their coccyx (tailbone). If the pain does not resolve on its own, and after a course of antiinflammatories and donut cushion, the ganglion impar is blocked under fluoroscopic guidance.
ICD-9 code: 724.79 (Coccydynia)
ICD-10 code: M53.3 (Sacrococcygeal disorders, not elsewhere classified)
CPT codes: There is no consensus on the correct code to use. Some use:
64530 (Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring).
64999 (Unlisted procedure, nervous system) and submit documentation of medical necessity.
64520 (Injection, anesthetic agent; lumbar or thoracic paravertebral sympathetic)
77003 (Fluoroscopic needle guidance for spine or paraspinous)
