Anesthesia Coding Alert

Question: What is the CPT Code for intradiskal electrothermal therapy (IDET)?

Oklahoma Subscriber

Answer: CPT does not include a specific IDET code, so many pain management coders opt for 64999 (Unlisted procedure, nervous system) despite their hesitation to use "unlisted-procedure" codes. If one physician performs the IDET and another administers the anesthesia, you should report either 01991 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; other than the prone position) or 01992 (... prone position) for the anesthesia provider.

If the carrier accepts "S" codes, you can report HCPCS codes S2370 (Intradiskal electrothermal therapy, single interspace) and S2371 (Each additional interspace [list separately in addition to code for primary procedure]) as appropriate.

Many carriers still consider IDET an experimental procedure. Include notes supporting medical necessity to help increase your chances of reimbursement. Diagnoses that help justify IDET include 724.2 (Lumbago), 722.73 (Intervertebral disc disorder with myelopathy; lumbar region), 722.10-722.11 (Displacement of thoracic or lumbar intervertebral disc without myelopathy) and 724.3 (Sciatica). Remember that the patient must have pain for three months or longer before he is an IDET candidate.

- Answers to You Be the Coder and Reader Questions were reviewed by Barbara Johnson, CPC, MPC, an anesthesia coder in Loma Linda, Calif.