Neurosurgery Coding Alert

Question: What is IDET? How should I code for it?

Oregon Subscriber


Answer: Intradiscal electrothermal annuloplasty, also called intradiscal electrothermal therapy (IDET), is a relatively new treatment (introduced in 1997) for back pain in which the physician applies high heat directly to the inside of the vertebral disc. The procedure is less expensive and less invasive than surgery but is usually reserved for patients who have unsuccessfully tried aggressive, nonoperative techniques to relieve their pain.

CPT contains no specific code to describe this procedure. CPT and AMA guidelines dictate, "Do not select a CPT code that merely approximates the service provided. If no such procedure or service exists, then report the service using the appropriate unlisted procedure or service code." Therefore, the best code choice to report this procedure is unlisted-procedure code 22899 (Unlisted procedure, spine).

Note that Medicare payers will not reimburse for this procedure because "peer-reviewed data lacks evidence of effectiveness, safety and long-term results."

Clinical and coding expertise for You Be the Coder and Reader Questions provided by Eric Sandham, CHC, CPC, compliance manager for Central California Faculty Medical Group, a group practice and training facility associated with the University of California at San Francisco in Fresno.