Neurosurgery Coding Alert
Category lll Codes Describe IDEA
Question: Should we use an unlisted-procedure code to report IDEA?
Missouri Subscriber
Answer: You should choose one of two HCPCS category III codes to describe intradiskal electrothermal annuloplasty (IDEA): 0062T (Percutaneous intradiskal annuloplasty, any method, unilateral or bilateral including fluoroscopic guidance; single level) or +0063T (... one or more additional levels [list separately in addition to 0062T for primary procedure]). If a category III code exists for your procedure, you must use it.
Therefore, you should not report an unlisted-procedure code such as 64999 (Unlisted procedure, nervous system) for IDEA unless your payer specifically instructs you to do so in writing. Codes 0062T and 0063T do not carry a relative value unit rating. Individual payers (rather than the yearly fee schedule) determine reimbursement (and coverage) for these procedures. Because many payers still consider IDEA an experimental procedure, you might not receive any payment. Even so, correct coding principles dictate that you report the procedure.
Bonus tip: For CT or MRI guidance and localization for needle placement and annuloplasty in conjunction with 0062T and 0063T, see 76360 (Computed tomography guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], radiological supervision and interpretation) and 76393 (Magnetic resonance guidance for needle placement [e.g., for biopsy, needle aspiration, injection, or placement of localization device], radiological supervision and interpretation).
Clinical and coding expertise for You Be the Coder and Reader Questions provided by Eric Sandhusen, CHC, CPC, director of compliance for the Columbia University department of surgery.
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Category lll Codes Describe IDEA
Question: Should we use an unlisted-procedure code to report IDEA?
Missouri Subscriber
Answer: You should choose [...]
