Neurosurgery Coding Alert

Question: Our surgeon did two spinal punctures in a single day. One was for diagnosis, and the second one was to relieve the increasing intracranial pressure. How can we code for these procedures? Can we submit both 62270 and 62272?

New York Subscriber

Answer: When your surgeon does two punctures on a single day, one for diagnosis and another subsequent one for treatment, you can report both procedures. You report 62270 (Spinal puncture, lumbar, diagnostic) along with modifier 59 (Distinct procedural service) and also report 62272 (Spinal puncture, therapeutic, for drainage of cerebrospinal fluid [by needle or catheter]) separately, one appended with modifier 59. 

Tip: Make sure you document clearly the necessity for both the punctures. Include the details of the diagnostic puncture and also document the results of the same. Subsequently, document the details and reasons for the therapeutic puncture. 

Exception: If your surgeon does the two procedures on two separate days, you can report both 62270 and 62272 as separate codes without modifier 59.