Anesthesia Coding Alert

Edits pair 62290, 62291 with fluoro guidance and ultrasound codes

Anesthesia and pain management coders will be happy to see this year's final round of quarterly National Correct Coding Initiative (NCCI) edits. The NCCI version 10.3 changes went into effect Oct. 1, 2004, and only have two edits that will impact your coding for pain management practitioners.

Edit 1: The edits indicate that the fees for diskography codes 62290 (Injection procedure for diskography, each level; lumbar) and 62291 (... cervical or thoracic) now include the two fluoroscopy and ultrasound codes. Radiology codes 76003 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]) and 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) are now considered components of 62290 and 62291.

Tip: The edits assign a status indicator of "1" to both pairs of codes. This means you can separately report the diskography and guidance codes under certain circumstances using modifier -59 (Distinct procedural service). Some coders recommend appending modifier -51 (Multiple procedures) instead because the physician performs the fluoroscopic guidance and diskography during the same session.

However, special rules apply when you unbundle procedure codes that the edits pair (such as sometimes needing a written radiology report). Be sure you have the correct supporting documentation before reporting services this way.

Edit 2: If you code for neurostimulator cases, NCCI 10.3 bundles 95974 (Electronic analysis of implanted neurostimulator pulse generator system [e.g., rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements]; complex cranial nerve neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming, with or without nerve interface testing, first hour) with two neurostimulator placement and removal codes. Code 95974 is now considered a component of codes 63685 (Incision and subcutaneous placement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling) and 63688 (Revision or removal of implanted spinal neurostimulator pulse generator or receiver).

For more information on all NCCI edits, log on to http://www.cms.hhs.gov/physicians/cciedits/default.asp?.