Neurosurgery Coding Alert

Lumbar gets a permanent code, but cervical still stuck in Category III CPT 2007 has hit the streets, and you will need to learn several new neurosurgery codes before Jan. 1. Coders will be most interested in the revisions the AMA made to the Category III codes, also known as -T- (Temporary) codes.

In the new manual, CPT has removed three disc arthroplasty codes from the Category III section and given them permanent codes, says Eric Sandhusen, CHC, CPC, director of compliance for the Columbia University department of surgery. Further, CPT has revised the definitions of the remaining Category III disc arthroplasty codes.

Here's a look at what changes CPT 2007 holds for neurosurgery practices.
 
Use 22857 for Lumbar Arthroplasties The latest edition of CPT significantly alters reporting methods for lumbar total disc arthroplasties. When your surgeon performs this procedure in 2007, you should report 22857 (Total disc arthroplasty [artificial disc], anterior approach, including discectomy to prepare interspace [other than for decompression], lumbar, single interspace), Sandhusen says.

Old way: Formerly, you had to code these arthroplasties with 0091T (Total disc arthroplasty [artificial disc], anterior approach, including discectomy to prepare interspace [other than for decompression]; single interspace, lumbar), which CPT deleted for 2007.

Coders are pleasantly surprised that CPT replaced the T codes so quickly. -It seems fast- to get a permanent lumbar arthroplasty code, says Denise Paige, CPC, coding and billing manager at Beach Orthopedic Associates in Long Beach, Calif., and the secretary of the AAPC's Long Beach Chapter.

According to Beth Janeway, CPC, CCS-P, CCP, president of Carolina Healthcare Consultants in Winston-Salem, N.C., moving lumbar total disc arthroplasties from Category III to Category I (permanent) code status is a sign that the procedure has gained more industry acceptance.

-CPT only assigns Category I codes when a procedure is safe and effective, and approved by physicians and the medical community,- she says. Moving lumbar arthroplasties to Category I -shows that the treatment has good outcomes, and that the procedure is going to stick around,- Janeway says. Experts: Coding Gets Easier With Category I Code Coders will have an easier time garnering payment for lumbar total disc arthroplasties with 22857 than they had with the T code, Janeway says. When a code moves from temporary to permanent status, Medicare assigns the code relative value units (RVUs). Once a procedure has RVUs assigned to it, Medicare and private payers will accept the treatment more widely, Janeway says.

There's also a new code for use when the surgeon performs a total disc arthroplasty on more than one lumbar interspace. When this occurs, report new code +0163T (Total disc arthroplasty [artificial disc], anterior approach, including discectomy to prepare interspace [other than for decompression], lumbar, each additional interspace) for each additional [...]