Neurosurgery Coding Alert

CPT 2007 UPDATE~ CPT Applies More Logic to Radiologic Guidance Codes

Published on Fri Jan 20, 2006

New manual groups guidance codes by modality

The CPT Codes 2007 manual holds many changes for neurosurgery coders, and the upheaval extends into the realm of radiologic guidance codes.

The codes you used for guidance in 2006 have been regrouped under new code numbers in the CPT manual 2007. For instance, you used to report 76986 for intraoperative ultrasonic guidance. However, you-ll report 76998 (Ultrasonic guidance, intraoperative) for the same service this year. The descriptor for 76998 is identical to the descriptor for 76986, but CPT wants coders to use the new code from now on.

When CPT regroups (or -crosswalks-) codes, the reason is usually to make the listings in CPT more logical. This is the reason for the crosswalking of the radiologic guidance codes in CPT 2007, says Eric Sandhusen, CHC, CPC, director of compliance for the Columbia University department of surgery.

-The definitions are the same, but the codes are in a different part of the manual. Now they are grouped by modality,- Sandhusen says of the guidance codes. In CPT 2007, there are three subsections in the Radiologic Guidance section -- Fluoroscopic Guidance, Computed Tomography Guidance, and Magnetic Resonance Guidance.

Check out this list of the new radiologic guidance codes and the CPT codes they replaced:

76003 deleted: To report this service, use 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]).

76005 deleted: To report this service, use 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint], including neurolytic agent destruction).

76006 deleted: To report this service, use 77071 (Manual application of stress performed by physician for joint radiography, including contralateral joint if indicated).

76012, 76013 deleted: To report these services, use 72291 (Radiological supervision and interpretation, percutaneous vertebroplasty or vertebral augmentation including cavity creation, per vertebral body; under fluoroscopic guidance) and 72292 (... under CT guidance).

76355 deleted: To report this service, use 77011 (Computed tomography guidance for stereotactic localization).

76360 deleted: To report this service, use 77012 (Computed tomography guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], radiological supervision and interpretation).

76370 deleted: To report this service, use CPT 77014 (Computed tomography guidance for placement of radiation therapy fields).

76393 deleted: To report this service, use 77021 (Magnetic resonance guidance for needle placement [e.g., for biopsy, needle aspiration, injection, or placement of localization device] radiological supervision and interpretation).

76394 deleted: To report this service, use 77022 (Magnetic resonance guidance for, and monitoring of, parenchymal tissue ablation).

76986 deleted: To report this service, use 76998

Remember, the descriptors for these services are the same as they were in 2006; you-ll just have to use different codes to represent them [...]

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