Some authors have described the. 5 months). hansur. Most men are able to return to their usual activities within 1 to 3 days after the procedure. 2014 Dec;18(4):158-9. 2 to 4 weeks: The cast and stitches are removed, and you'll be given a plastic splint to stabilize the wrist. 2 to 0. 0 cm (12046)2. Methods A systematic. The procedure addresses the “supply” of pain to the brain, dissecting and removing the nerve branches of the joint rather than altering the joint itself. 5 cm (12044) Layer closure of wounds of neck, hands, feet and/or external genitalia; 12. 008. 6 cm to 12. 2019 Jun;238:144-151. My physician performed an Epidural Lysis and performed three injections over the course of three days. Hand surgeons who document thumb carpometa-carpal stabilization" " "Eaton procedure" or "LRTI" in their notes often stump orthopedic coders who cannot locate any such descriptors in CPT. 53 may differ. 33-)Denervation of the wrist may be a good alternative in patients who are not candidates for these procedures or who cannot afford to lose motion or spare the time to recuperate from larger surgical interventions. Excision Procedures on the Hand and Fingers. 29845 . 3)Adipose-derived mesenchymal stem cell (ASC) therapy is currently a focus of regenerative medicine. 26230. The CMC joint, the focus of this paper, is referred to as the basal joint of the thumb, reflecting its proximal location within the digit. Claims for (onabotulinumtoxinA), should be submitted under HCPCS code J0585. dcepeda New. 04. }, author={Raymond Rath and Max Haerle. CPT ‡ Code 2019 Payment3 2020 Payment1 % Change 2019 Payment4 2020 Payment2 % Change Hypertension Renal Denervation Renal denervation, unilateral 5192 0338T $4,679 $4,953 5. net. Ramsey SD, Berry K, Etzioni R, et al. . 120 - Facet Arthroplasty Facet Joint Denervation Description Percutaneous radiofrequency (RF) facet denervation is used to treat neck and back pain originating in facet joints with degenerative changes. Partial denervation can be performed with one or two incisions and typically involves transection of the posterior and anterior interosseous nerves. Typically, patients have pain in the base of the thumb and with the progression of the disease: atrophy of thenar muscles, subluxation of the first carpometacarpal joint, loss of pinch and grip. 84). 5 months). Page 5 of 18 . For the study cohort, the conversion rate to T + LRTI at 2 years was 9%. As a part of routine workup for CMC arthritis patients receive a hand xray. CPT Codes. For coding purposes, these two injections are considered a single injection service. 1,2 Although debated, the cause of this condition is generally thought to be mechanical wear. For the procedure, our surgeon will make several small incisions in the affected area to meticulously and. 5 months for denervation group and 26. #1. This is the American ICD-10-CM version of M26. Wrist denervation has been shown to provide long-term pain relief in at least 80% of patients (11, 12). 001) reduction in pain scores from baseline (M = 6. 3 weeks vs 4. Do not report modifier 50 in conjunction with 64491, 64492, 64494, 64495. g. A57826 - Billing and Coding: Facet Joint Interventions for Pain Management A58658 - Response to Comments: Facet. NCT03558204. 20612 Aspiration and/or injection of ganglion cyst(s) any location 20615 Aspiration and injection for treatment of. 3 weeks vs 4. It lies at first slightly lateral to the radial artery, concealed beneath the Brachioradialis. 2) Traumatic arthropathy, forearm (716. Fluoroscopic and CT guidance and. Hand surgeons who document thumb carpometa-carpal stabilization" " "Eaton procedure" or "LRTI" in their notes often stump orthopedic coders who cannot locate any such descriptors in CPT. ICD-10 Codes Description K11. 0) Pain in joint, forearm (719. The scope is then removed and the incisions are closed. Denervation of the first CMC joint is a relatively new procedure for managing stable thumb CMC. Neurectomy of the anterior interosseus nerve. 2022. 1007/s11552-007-9068-9. Table 4. Injections for plantar fasciitis are addressed by 20550 and ICD-10-CM M72. This review aimed to summarise the available evidence and to propose a research agenda. 05). Between October 2005 and August. Authors. 8 First described in 1991, thumb CMC denervation has reported success rates in the literature ranging from 35% to 87% in patients with symptomatic osteoarthritis. Carpometacarpal (CMC) arthroplasty surgery, although modifications have occurred over time, continues to be commonly performed and has provided patients with their desired pain relief and return of function. Post-operative VAS decreased to an average of 3. Remember Me. To apply the principles of therapeutic joint denervation to treat thumb CMC arthritis, a basic understanding of the innervation patterns to the CMC joint is needed. All patients who underwent first CMC joint denervation surgery from January 2015 through September 2017 were retrospectively identified. My physician performed an. Prospective Clinical Trial Comparing Trapezial Denervation With Trapeziectomy for the Surgical Treatment of Arthritis at the Base of the Thumb J Surg Res. 10 $761 CMC Joint Fusion CPT® Code Description 2020 Total RVUs 2020 Medicare National Average Payment 26841 Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; 21. 61 ± 2. 16 Salibi et al16 also chose a prospectivePROCEDURE PERFORMED: Decompression median nerve, forearm. Neurectomy of the dorsal radial sensory nerve articular branches. 2019. sympathetic denervation in patients with resistant hypertension. 14,16,19 The baseline pain scores and postoperative pain scores from these studies were pooled and analyzed using a 2-sided paired t test (α = 0. Average follow-up of patients was 26. Surgical denervation of the thumb carpometacarpal (CMC) joint is a theoretical surgical option for thumb CMC arthritis. 5, 52, and 66. Hand Surg Rehabil. or depending on the insurance plan use 25210 x (times) # of bones, up to 4. PMCID: PMC2527221. Among the 6 patients who had previously undergone spinal surgery, 2 (33. Selective denervation of the CMC joint is an effective approach to treat pain and alleviate impairment associated with CMC arthritis. Arthroscopy. Back to work the day after. It pierces the deep fascia of the forearm approximately 7 cm proximal to the radiocarpal joint (9 cm proximal to radial styloid) runs over snuff box to supply dorsal radial surface of hand. Solutions . 40 TABLE 3. Reg Anesth Pain Med 2007; 32(6):495-503. Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant (P < . Neurectomy of the dorsal radial sensory nerve articular branches. 2. Long-term follow-up after ligament reconstruction with tendon interposition. Trapeziectomy as a treatment of first carpal-metacarpal (CMC) joint has been reported for almost 70 years . Surgical Procedures on the Musculoskeletal System. My provider is looking to do a lateral antebrachial neurectomy on a patient for forearm pain likely secondary to inflamed sensory nerve that runs across the fistula. Straightforward – 10 minutes: 99212. 12) Carpometacarpal dislocation, closed (833. g. 8 months, range = 3-90 months). Objective. Keywords: Denervation, CMC, joint. 030 To determine the innervation pattern to the thumb carpometacarpal (CMC) joint and assess the safety and efficacy of selective. However, the innervation pattern of the thumb CMC joint is controversial. Best answers. Carpometacarpal denervation appears to provide similar short-term outcomes as suspension arthroplasty for the treatment of thumb carpometacarpal arthritis. You would have to use 55899. Occipital Nerve (CPT Code 64744) for Treatment of Headaches . + 64634 each additional facet joint (List separately in addition to code for primary procedure) 64635 Destruction by neurolytic. All VT episodes occurred in the first 4 months after ablation (2. Results Of 169 references, 17 articles reporting on 384 denervations in 351 patients were selected. CPT code 64625 has been added to CPT/HCPC Codes Group 2 effective for dates of service on or after 01/01/2020. Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant (P < . 001) reduction in pain scores from baseline (M = 6. New Haven, IN. Besides denervation and arthrodesis, arthroplasty is a valuable alternative treatment. Results for a total denervation of the first CMC joint are given in Table 4. Joint denervation presents a number of theoretical advantages over more. 1. 11) Metacarpal base fracture, open (815. Pain scores for AKP were significantly better in the denervation group at 3 months but not at 12 and 24 months. Between 2006 and 2018, 46 patients underwent the procedure in our clinic and were included in this retrospective study. Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant (P < . I am hesitant, would this approach my provider is describing qualify as MIS as he states his approach is. Prospective studies with validated patient-reported and objective outcome measures between distinct treatment arms, such as denervation versus ligament. Complete wrist denervation through a dorsal approach including neurectomy of the posterior. interosseous nerve. 1. 01. Basilar Thumb Arthritis is a form of arthritis that causes pain at the base of the thumb and difficulty with pinching and grasping due to carpal-metacarpal (CMC) joint arthritis. These services should be reported with CPT code 64999. It can be of particular benefit in. A graft jacket was rolled. Late effect of hardware or graft (996. Selective denervation has been successfully employed to treat arthritis pain in a number of joints throughout the body. ”. In an Ambulatory Surgical. A CMC arthroplasty was performed along with excision of the trapezoid bone. No hemodynamic deterioration or worsening of renal function was observed. 0. 00 57250 Posterior repair, rectocele N/A $614 N/A 17. 1 Department of Orthopaedic Surgery and Sports Medicine, Temple University Hospital, 6th Floor OPB, Philadelphia, PA, 19140, USA. , wrist denervation substantially reduces pain in radiocarpal osteoarthritis [6–10]. Abstract and Figures. 10. Innervation of the dorsal aspect of the wrist joint. To appropriately report any of these modalities, use 64999). Video marketing. 2) Late effect of. 03. Non-thermal facet joint denervation (including chemical, low grade thermal energy [<80 degrees Celsius] or any other form of pulsed radiofrequency) should not be reported with CPT codes 64633, 64634, 64635 or 64636. Foucher et al. Vaseghi M, Zhou W, Shi J, Ajijola OA, Hadaya J, et al. 61 ± 2. 0. 27). Each trade name corresponds to a specific CPT code that requires PA. Carpometacarpal Joints /. 03) to postoperatively (M = 1. First carpometacarpal (CMC) joint osteoarthritis (OA) is commonly encountered in clinical practice. This procedure is performed when all other treatment options. It is a procedure used for pain relief purposes in conditions such as advanced wrist arthritis, following wrist fractures, or severe ligament injuries. Thumb carpometacarpal (CMC) joint arthritis is a common problem affecting 7% of men and 15% of women, 1 many of whom experience debilitating pain, weakness, and functional limitations. 11) Metacarpal base fracture, open (815. Arthroplasty with prosthetic replacement, trapezium (25445) Interposition arthroplasty, intercarpal or carpometacarpal joints (25447) Partial Trapezoid excision. Arthroplasty of the basal joint of the thumb. Event marketing. Trap: Some coders report 26480 for every transfer because the surgeon always transfers the tendon to the carpometacarpal area. 81) Late effect of dislocation (nonspecific) (905. Medical Coding. 052. CPT Codes. You may report only a single unit of either 64646 or 64647, per session. | Find, read and cite all the. 4: PIN. Messages 167 Location Conway, SC Best answers 0. doi: 10. 0001). From an Orthopedic standpoint, "arthritis of the base of the thumb" most likely & commonly refers to arthritis of the First Carpometacarpal Joint of the thumb, M18. C. The traditionally more extensive wrist denervation has evolved to procedures requiring fewer incisions. Outcomes following isolated posterior interosseous nerve neurectomy: a. Lipoaspirate is rich in ASCs and is evolving into a promising, less-invasive tool to treat thumb carpometacarpal osteoarthritis as compared with common surgical techniques, for example, trapeziectomy or prosthesis implantation. 64636 for non-thermal joint denervation including chemical, low-grade thermal energy (<80 degree Celsius), or any form of pulsed radiofrequency. 2-fold increase in the incidence of non-denervation CMC OA surgery over that same time (Figure 1B). Carpal bone dislocations: an analysis of twenty cases with relative emphasis on the role of crushing mechanisms. 3 The avascular. ablation or denervation is an effective treatment for occipital neuralgia or headaches. NCT03558204. Local Coverage Determinations. 6, and 55. Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. CPT® Code Description PI 2021 Medicare National ASC Average Payment 2021 Medicare National Average Physician Payment (Facility Setting) 27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft J8 $8,833 $1,322 Ambulatory Surgical Center Physician CPT® Code. Arthrotomy, for infection, with exploration, drainage or removal of foreign body; carpometacarpal joint (26070) Arthrotomy, for infection, with exploration, drainage or removal of foreign body; metacarpophalangeal joint (26075) Arthrotomy, for infection, with exploration, drainage or removal of foreign body; interphalangeal joint, each (26080)Forearm deep fascia. 26841. For every operated hand, the Kapandji score, key-pinch strength, grip strength and pain on a. Mission & Cause Our Mission. Basilar Thumb Arthritis is a form of arthritis that causes pain at the base of the thumb and difficulty with pinching and grasping due to carpal-metacarpal (CMC) joint arthritis. Botulinum toxins are used in the treatment of overactive skeletal muscles, smooth muscles, and glands. 0 branch at the fifth carpometacarpal (CMC) joint (range, 0–2; Table 1). 3. 90 cm from the Listers tubercle. ICD and CPT Codes for Hand Surgery. In all studies, joint denervation improved pain and hand function at follow-up (M = 36. C. 26215. The ulna may be approached through a skin incision over the distal ulna or through a dorsal incision over the radioulnar joint. Carpometacarpal (CMC) joint/trapeziometacarpal (TMC) joint implants: HCPCS codes not covered for indications listed in the CPB: C1776: Joint device (implantable). Patient with right thumb metacarpophalangeal (MCP) joint instability, carpometacarpal (CMC) osteoarthritis, and wrist scaphotrapeziotrapezoidal (STT) arthritis presents for treatment of the thumb and wrist. 28 (P<0. The CPT code 25447, which included all interposition procedures whether with tendon, allograft, or artificial material, was the most common procedure queried, and it was analyzed as a separate. Botulinum toxins are used in the treatment of overactive skeletal muscles, smooth muscles, and glands. 4 million people in the UK have osteoarthritis of the hand, requiring two million primary care consultations per annum. 2nd hole thru dorsal cortex distal to the base of thumb metacarpal. 69 ± 1. Joint denervation presents a number of theoretical advantages over more traditional surgical options; it is minimally invasive, it does not require a prosthesis or postoperative immobilisation, and does not preclude future surgery. Can you bill out 25210 more than once, example doctor excised the trapezium, scaphoid, & lunate. 25% bupivacaine. The CMC joint of the thumb is a saddle joint. The posterior interosseous nerve travels along the posterior aspect of the forearm between the ulna and the radius. Denervation of the proximal interphalangeal joint: a realistic and simple procedure. Age-group and sex analyses are reported as numberFBN. CPT Coding 0440T Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve. Note: Report CPT code 64999 when facet cyst aspiration/rupture. 7 to 0. 03) to postoperatively (M = 1. Search by ICD9. The combined. Basilar Thumb Arthritis. Between June 1995 and June 2013, a total of 648 patients underwent SPD for ST. Medical conditions that can affect the thenar eminence include carpal tunnel syndrome, arthritis, and amyotrophic lateral sclerosis (ALS), among others. The clinical outcomes were more effective in the early-stage group (Eaton stages I and II. 5 cm (12044) Layer closure of wounds of neck, hands, feet and/or external genitalia; 12. 1016/j. Three incisions were made (Fig. 26820. The insurance company is denying the 64627 stating this is an. #5. The qualified healthcare providers injects a diagnostic or therapeutic agent into a facet joints to treat the spinal pain or to identify the exact source of pain with using of imaging guidance of either fluoroscopy or CT scan. Code 25442, Arthroplasty with prosthetic replacement; distal ulna, is a procedure in which the distal end of the ulna is removed and replaced with a prosthesis. Lipoaspirate is rich in ASCs and is evolving into a promising, less-invasive tool to treat thumb carpometacarpal osteoarthritis as compared with common surgical techniques, for example, trapeziectomy or prosthesis implantation. Microsurgical denervation of the spermatic cord is one surgical treatment Dr. 10. 0000000000000057. CPT has several codes (64732-64772) relating to the excision or transection of the nerves. Neurectomy of the dorsal radial sensory nerve articular branches. In the middle third of the forearm, it lies behind the same muscle, close to the lateral side of the artery. doi: 10. 2 [6, 8, 23,24,25,26,27]. Other patients may be better served with a vasectomy reversal, conversion to an open-ended vasectomy, excision of a sperm granuloma, or epididymectomy. Jan 25, 2017. American. This study compared functional/patient-reported outcomes after CMC denervation with those after trapeziectomy and ligament. Pen – clicking type; Gloves – non. 1097/BTH. Pain in joint, forearm (719. We performed a retrospective outcome analysis of patients with symptomatic stage II-III thumb CMC joint arthritis treated with denervation, joint lavage and capsular imbrication. and fourth carpometacarpal joints ( Fig. Page 5 of 18 . PMID: 18780059. PHYSICAL THERAPY. 001) reduction in pain scores from baseline (M = 6. Only patients with a good response to injection were selected for surgical. 02) Metacarpal shaft fracture, closed (815. 0 cm (12046)Article Guidance. Methods In this paper, we present a 4- to 6-year follow-up case series on patients who underwent CMC denervation between 2015 and 2017. 12) Carpometacarpal dislocation, closed (833. Denervation of the thumb CMC joint has emerged as a viable treatment option to manage pain related to OA. wneu. 2018. 67, p < . 67, p < . 1,2 The mechanism usually occurs during hyperextension from high-velocity blunt trauma, mainly punching or falling. Terminal branches. Best answers. clinical literature on CMC denervation for CMC OA. Intradiscal biacuplasty uses two internally water-cooled radiofrequency probes to lesion nociceptors in the intervertebral disc. 1016/j. jss. reported less promising results, with only 32% patient satisfaction in their series of 36 joints [22]. 2 (5. The denervation of the first CMC joint has gained traction as a viable treatment for CMC arthritis. 21) Late effect of sprain/strain (nonspecific) (905. Radiographic changesinclude. The present study aimed to examine the effect of 1 mL intraarticular. 43) Crushing injury, wrist (927. Carpal bone dislocations: an analysis of twenty cases with relative emphasis on the role of crushing mechanisms. Arthrotomy, for infection, with exploration, drainage or removal of foreign body; carpometacarpal joint (26070) Arthrotomy, for infection, with exploration, drainage or removal of foreign body; metacarpophalangeal joint (26075) Arthrotomy, for infection, with exploration, drainage or removal of foreign body; interphalangeal joint, each (26080)This pain affects the quality of life in 2. according to your report the doctor is using RF Denervation for all levels, you code per nerve root meaning L3-L5=2 nerve roots, two levels, L5-S1=2 nerve roots, two levels; all four bilateral, so the correct coding should be: L3-L5, L5-S1 facets (bilateral L3,L4, "L5" medial branches)) codes and Healthcare Common Procedure Coding System (HCPCS) codes listed in this policy are for reference purposes only. denervation treatment option, many desired that op-tion over arthroplasty due to the perception that denervation was less invasive. Safety of denervation following targeted lung denervation therapy for COPD: AIRFLOW-1 3-year outcomes. I have found a couple of payer policies that state to bill an endoscopic rhizotomy with CPT code 64999 or they deem it experimental all together. Complete wrist denervation through a dorsal approach including neurectomy of the posterior. 16. Aetna considers total wrist arthroplasty medically necessary for rheumatoid arthritis affecting the wrist in persons who have radiographic evidence of wrist joint destruction with demonstrated resistance or failure to conservative medical treatment (3 or more months of non-steroidal antiinflammatory drugs (NSAIDS), disease modifying. Coverage is subject to the specific terms of the member's benefit plan. Tech Hand Up Extrem Surg. 64490 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint). The recommended code for these excisions is 64772. 2017;25(6):439-447. Neurectomy of the dorsal ulnar sensory nerve articular branches. American Society for Surgery of the Hand assh. (in the Physicians & Surgeons Offices. 26841. 2 The most commonly involved joints are the fourth and fifth CMC joints. Results Preoperative average Quick Dash was 47. Documentation, Utilization and ICD-10-CM coding sections have been added. The Tenodesis Screw with a convenient disposables kit the CMC Ligament Reconstruction Kit will enable a faster, more convenient repair providing strong and immediate fixation of the tendon graft. Phase. Remember Me. The thenar eminence is composed of three muscles that control the movements of the thumb: abductor pollicis brevis (APB), flexor pollicis brevis (FPB), and the opponens pollicis. the risk/benefit ratio for CMC joint treatment. H J Klein , 10. This article was converted to the new Billing and Coding Article type. Medical notes documenting the following, when applicable: Upon request we may require. Hi, CPT has several codes (64732-64772) relating to the excision or transection of the nerves. 69 ± 1. 20 . Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans. The 24359 has to do with the tendon and the 64718 is focused on the nerve - 2 different animals. e1-64. Prospective. Carpectomy; one bone (25210) Index Metacarpal base. 6 cm to 12. Foucher was convinced that. 4 to 6 weeks: Physical therapy begins. Some authors have described the nerve branches of thumb CMC joint. A systematic review was performed on all published literature relating to thumb CMCJ denervation. For requests for non-pulsed radiofrequency denervation of cervical facet joints (C2-3 and below), thoracic facet joints, or lumbar facet joints, please provide the following current clinical notes:Denervation patients had a reduced time to return to function (3. At the time of the study design, the only other comparative study examining denervation and arthroplasty for the treatment of CMC arthritis of the thumb was by Salibi et al. What are the risks of CMC ligament repair? You may bleed more than expected or get an infection. Hope this helps. Direct the MACs to review claims for denervation sessions after the OIG’s audit period (dates of service from. 4) Removal of implant; superficial, eg, buried wire, pin or rod) separate procedure removal hardware (20670) Removal of implant; deep, eg, buried wire, pin, screw, metal band, nail, rod or plate) removal of hardware (20680) Implant removal, elbow joint (24160)This is "Surgical Denervation of the Thumb Carpometacarpal Joint" by ASSH on Vimeo, the home for high quality videos and the people who love them. 04 closed or 833. and therapeutic facet joint injections, facet joint denervation, and facet cyst aspiration/rupture as described by CPT® codes: 64490 Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or. • Cooled radiofrequency ablation for facet denervation (e. Epub 2019 Feb 13. A needle or Answer: The carpometacarpal joint is considered a small joint, therefore, it is appropriate to report code 20600, Athrocentesis, aspiration, and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance, for this procedure. 1,2 Blood pressure (BP) remains sub-optimally controlled in up to 25% of these patients, often attributed to medical non-adherence and resistant disease despite appropriate medical. 29843 . hansur. It is concluded that volar CMC joint denervation is a useful procedure, preserving joint function and relieving pain long-term. 0001). ICD-10 Codes Description K11. 541 - M12. Neurectomy of the dorsal ulnar sensory nerve articular branches. 2 percent of men with this problem. Complete wrist denervation through a dorsal approach including neurectomy of the posterior. 25449 . 10. It can be hypothesized that part or all of the pain relief. Non-thermal facet joint denervation (including chemical, low grade thermal energy [<80 degrees Celsius] or any other form of pulsed radiofrequency) should not be reported with CPT codes 64633, 64634, 64635 or 64636. Enrollment will occur at the time. Thumb carpometacarpal osteoarthritis (CMCJ OA) is a common problem. The chart below identifies which trade name. 2 A cost analysis study conducted in the. Results. Arthrodesis Procedures on the Hand and Fingers. CMC OA affects 66% of women older than 55 years 1 and an estimated 22% of the general population aged 50 years and over are symptomatic 2. #1. 54 “pain in a joint, hand” CPT code: 20600 “Arthrocentesis, aspiration and/or injection; small joint or bursa (eg, fingers, toes)” Materials Needed. Ask Dr. The superficial branch of the radial nerve passes along the front of the radial side of the forearm to the commencement of its lower third. LAPAROSCOPIC LIVER BIOPSY CPT code(s) to report Descriptor Global period Work RVU Total RVU 47562 Laparoscopy, surgical;. 2 to 4 weeks: The cast and stitches are removed, and you'll be given a plastic splint to stabilize the wrist. Phase 3: Studies that gather more information about safety. It can be hypothesized that part or all of the pain relief. Thumb CMC denervation was first specifically described in 1991, with success rates varying from 35% to 87%.