Anesthesia Coding Alert

Question: Should I report modifiers when the physician performs diskography at multiple lumbar levels? It appears that Medicare does not accept some modifiers but will accept others.


Arkansas Subscriber

Answer: Report the diskography with 62290 (Injection procedure for diskography, each level; lumbar) for each injection. Don't use a modifier for the first injection, but append modifier -59 (Distinct procedural service) for each additional injection. Some coders recommend that you list the levels injected in Box 19 of the HCFA 1500 form (such as 62290 = L2-L3 and   62290-59 = L3-L4 and L4-L5).

You'll do the same for the radiographic portion of the procedure. Report 72295 (Diskography, lumbar, radiological supervision and interpretation) for the first site and append modifier -59 for each additional site studied. When you report 72295, remember it includes both supervision and interpretation. Add modifier -26 (Professional component) if your physician doesn't own the fluoroscopy equipment or if the facility will bill for that portion.

If you're billing for both the professional and technical components of the fluoroscopy, do not add modifier -26. Instead, note in Box 19 that the physician owns the equipment so the carrier knows you didn't forget to submit a modifier.

Reporting diskography can be a carrier-specific issue, so check the local guidelines.