# Help with case, discectomy...



## awest (Jan 21, 2011)

How would this be coded?  63030...62287...62290...not quite sure, new to pain coding.

Compression boots were placed on legs and arms were positioned in standard fashion.  Once we done this, we then prepped and draped the operative area in sterile fashion.  Through a left-sided approach, we used an 18-gauge Wolf needle and cannulated the L5-S1 disc space.  We identified this on oblique views as well as AP and lateral views.  Once we cannulated the disc space adequately, we then went ahead and placed a small guidewire through the needle and removed the guidewire.  I made a small stab incision approximately 0.5 mm in length down to lumbodorsal fascia and then placed a working trocar cannula over the guidewire and cannulated L5-S1 disc space on the left side.  Once we had successfully done this, I summoned ___01:44_______ issues were of the L5-S1 foramen as well.  I went ahead and placed a working cannula and removed the guidewire and then checked AP and lateral views and they were adequate position.  
I then placed a pituitary rongeur and did a manual discectomy as well.  I removed a significant amount of disc material which was sent for permanent specimen.  Once we successfully done this, we then used our YAG holmium laser and did our complete endoscopic discectomy with partial nucleoplasty as well at the L5-S1 level.  Once we done with YAG with power and wattage, we went ahead and created a nice cavity.  I removed the working cannula with the laser.  We checked final films.  There was no remnant of anything behind and then I copiously irrigated the small wound.  It was reapproximated using Steri-Strips.  Sterile dressing was applied.  The patient was sent to recovery room in stable condition and neurologically intact.  No change in neurological monitoring.


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## dwaldman (Jan 22, 2011)

http://www.ama-assn.org/ama1/pub/upload/mm/362/cptcat3codes.pdf

See page 6 -----0275T implemented July 2011 

64999 or 62287. S code?  But this does not seem like you would want to say this is 63030


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## awest (Jan 24, 2011)

Thanks for the information on the new code, I've printed that out and will have to remember that come July.  I'm thinking I would use 62287, but I'm not sure if there was a discogram done as well.


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## dwaldman (Jan 24, 2011)

Below is a CCI check I ran thru Supercoder, as you can see NCCI edits prevent the reporting of a discogram with a percutaneous discectomy.


62287 Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method, single or multiple levels, lumbar (eg, manual or automated percutaneous discectomy, percutaneous laser discectomy)



CCI Validation Results:

There are no bundling issues for this code.62290Injection procedure for discography, each level; lumbar



CCI Validation Results:

Code 62290 is a column 2 code for 62287, These cannot be billed together in any circumstances.

Code 62290 bundle with code 62287. Code 62290 cannot be billed with code 62287.

CCI edit Rule:
Misuse of column two code with column one code

9.7772295Discography, lumbar, radiological supervision and interpretation



CCI Validation Results:

Code 72295 is a column 2 code for 62287, These cannot be billed together in any circumstances.

Code 72295 bundle with code 62287. Code 72295 cannot be billed with code 62287.

CCI edit Rule:
Misuse of column two code with column one code


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## awest (Jan 25, 2011)

DUH, I don't know why I didn't run that! Thank you so much. I have supercoder too, guess I was thinking too much.  It makes sense now.


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