Neurology & Pain Management Coding Alert
Get Details Right to Nail Discography/Decompression Dilemma
Remember, one is surgical, the other diagnostic. If you don’t know the difference between a disc decompression and an injection for discography, you should get all the info you can before coding either of these services again. Why? There are different CPT® codes, and coding conventions, for each service. Further, you’ll need to know what other services you could potentially code for in order to submit the cleanest claims possible. Check out what our experts had to say about disc decompressions and injections for discography. Look to 62287 for Decompression You’ll report 62287 (Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with discography and/or epidural injection(s) at the treated level(s), when performed, single or multiple levels, lumbar) for disc decompressions, confirms Dreama Sloan-Kelly, MD, CCS, president of Dr. Sloan-Kelly Consulting in Shirley, Mass. Definition: Disc decompression is a needle-based percutaneous procedure. “Because it is percutaneous, the use of fluoroscopy or an endoscope is needed to visualize the placement and maneuvering of the needle,” Sloan-Kelly says. If your provider uses these visualization means, be sure you don’t code them separately from the disc decompression — they are bundled into 62287. “This code also includes discography, and/or epidural injection at the treated level, when performed and is limited to single or multiple lumbar vertebra,” explains Amy Pritchett, CCS, CPC-I, CPMA, CDEO, CASCC, CANPC, CRC, CDEC, CMPM, C-AHI, senior consultant at Pinnacle Enterprise Risk Consulting Services LLC, Centennial, Colorado. Discography Code Depends on Anatomy While there is a single code for disc decompressions, things get a little more complicated when considering codes for discographies. “Discography is a diagnostic study that injects contrast into the intervertebral disc, and is coded based on [spinal] level,” Sloan-Kely explains. You’ll also code separately for visualization — unlike claims for 62287. Breakdown: Use the following codes for discographies: For lumbar discographies, report 62290 (Injection procedure for discography, each level; lumbar) and 72295 (Discography, lumbar, radiological supervision and interpretation). For cervical/thoracic discographies, report 62291 (… cervical or thoracic) and 72285 (Discography, cervical or thoracic, radiological supervision and interpretation). Explanation: “The 62290 and 62991 codes are the injection procedure for the discography; the 72295 and 72285 codes are the discography procedure itself,” Sloan-Kelly says. Discography Claim Should Reflect Previous Tx When you’re coding for a discography, be sure the notes must reflect that your provider attempted to alleviate the patient’s symptoms via less aggressive methods. Each payer will likely have its own rules on the type and amount of less aggressive methods you must use before opting for discography. Payers will also almost certainly have list of qualifying conditions that are approved for discography.
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