Neurology & Pain Management Coding Alert

Did you conquer the coding conundrums of 2008? Find out now.

Before you set aside that last superbill of -08, take a few minutes to see how well you-ve retained some of neurology's quirkier coding elements from past issues of Neurology Coding Alert. Grab your coding manuals and a #2 pencil to get started!

Question 1: The correct diagnosis code for cervical facet arthritis is:

a) 721.0 -- Cervical spondylosis without myelopathy

b) 721.5 -- Kissing spine

c) 721.9 -- Spondylosis of unspecified site.

Hint: Look at Vol.10, No. 5, for a clue.

Question 2: You receive a denial on a claim for code +90766 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; each additional hour [List separately in addition to code for primary procedure]). The service billed was an IV steroid infusion and your physician marked the charge ticket with 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug) and the 90766 code. The most likely reason for the denial is:

a) Bureaucracy caused a misunderstanding and the denial is wrong

b) The initial charge code is incorrect

c) Trick question -- there is no +90766 code.

Hint: It's not a trick question, but it is a 2008 code. Look at Vol. 10, No. 8 for a tip.

Question 3: Neurologists often use Tysabri (formerly known as Antegren) to treat and reduce the frequency of clinical relapses of multiple sclerosis. Typically patients receive the drug as an intravenous infusion. The correct code for the Tysabri drug is J2323 (Injection, natalizumab, per 1 mg).

TRUE FALSE

Hint: The correct code changed on Jan. 1, 2008. Look up Vol. 10, No. 9, for more information.

Question 4: Your physician performs an epidurogram (72275, Epidurography, radiological supervision and interpretation). You may report 72275 only if the neurologist performs the separate diagnostic study, obtains hard copy images of the epidurogram in multiple planes, and prepares a formal radiologic report of his interpretation.

TRUE FALSE

Hint: Bundling can come into play here. Check out Vol. 10, No. 10, for help.

Question 5: When coding an EMG on both lower extremities, use 95860 (Needle electromyography; one extremity with or without related paraspinal areas) and append modifier 50 (Bilateral procedure) to report the bilateral procedure.

TRUE FALSE

Hint: Vol. 10, No. 11, has the answer.

Question 6: Your neurologist performs right C5-C6 and left C5-C6 facet joint injections. You should report 64470 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; cervical or thoracic, single level) with a single unit of service with which modifier appended?

a) Modifier 50 (Bilateral procedure)

b) Modifier 51 (Multiple procedures)

c) Modifier 59 (Distinct procedural service)

Hint: Find the answer in Vol. 11, No. 1.