Neurosurgery Coding Alert

Retroactive change could mean lost money found

The national Correct Coding Initiative (CCI), version 13.3, which took effect Oct. 1, will delete an edit that made cervical discectomy code 63075 (Discectomy, anterior, with decompression of spinal cord and/or nerve root[s], including osteophytectomy; cervical, single interspace) mutually exclusive with cervical arthroplasty code 0090T (Total disc arthroplasty [artificial disc], anterior approach, including discectomy to prepare interspace [other than for decompression] cervical; single interspace). This edit took effect last April and spelled a huge reimbursement shortfall for neurosurgeons--who could no longer bill for discectomy for decompression with arthroplasty.

Memphis, Tenn.-based manufacturer Medtronic launched a protest and convinced Medicare to revoke this edit, retroactive to its beginning in April.

Take action: If you received any denials due to this edit, you should resubmit the claims to your carrier after Oct. 1 to gain any payments you deserved, according to a letter from Correct Coding Solutions (CCS), which organizes CCI.

In other CCI news: Version 13.3 makes spinal manipulation code 22505 a component of most of the codes in the spinal surgery section from 22532 to 22865. A modifier will do you absolutely no good in dealing with those edits.

Finally, dural/cerebrospinal fluid leak repair codes 63707-63709 become components of a host of nervous system surgery codes, including most of the codes in the 63001-63307 section. You can escape from these edits using a modifier--but make sure your documentation explains why the fluid leak repair wasn't just part of the laminectomy or other surgery.