Neurosurgery Coding Alert

Question: I have an operative report that is quite puzzling. Notes indicate that the neurosurgeon performed a -Racz procedure.- What exactly is this procedure, and what code should I use to represent it?


Michigan Subscriber
Answer: -Racz procedures- are also known as epidural lysis of spinal adhesions. The surgeon may perform one of these to break down scar tissue in a patient who has pain.

Coding for Racz procedures depends on the number of days the surgeon leaves the catheter in the patient. He may insert and remove the catheter in the same day, or he may leave the catheter in place for several days so he can continue to treat the patient's scar tissue.

If the neurosurgeon inserts and removes the catheter in the same day, report 62264 (Percutaneous lysis of epidural adhesions using solution injection [e.g., hypertonic saline, enzyme] or mechanical means [e.g., catheter] including radiologic localization [includes contrast when administered], multiple adhesiolysis sessions; 1 day) for the procedure.
 
If the neurosurgeon inserts the catheter and leaves it in for two days or more, report 62263 (... 2 or more days).