Neurosurgery Coding Alert
Take the Guesswork Out of Coding X-Stop Procedures
Question: We have never done an X-stop procedure. How should I report it, and what is the reimbursement like? New Mexico Subscriber Answer: You should report your surgeon's services with the following T codes: - 0171T - Insertion of posterior spinous process distraction device (including necessary removal of bone or ligament for insertion and imaging guidance),lumbar; single level - +0172T -- ... each additional level (List separately in addition to code for primary procedure) (use 0172T in conjunction with code 0171T). Some coders report approximately $400 in reimbursement from Medicare, the only carrier who is paying for this procedure. Check your payer guidelines. CPT instructions are clear on the use of Category III codes -- report them whenever available. Because coverage and reimbursement remains a payer decision, you should follow the same process with reporting Category III codes as you do with unlisted procedure Category I codes. With Category III codes, you-re not only following the instructions provided by CPT, but you-re paving the way toward a potential Category I code in the future. Best bet: Stay current on your carriers- rules regarding Category III codes, and go ahead and submit claims with supporting documentation. Technical and coding guidance for You Be the Coder and Reader Questionsprovided by Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison.
Neurosurgery Coding Alert
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Take the Guesswork Out of Coding X-Stop Procedures
Question: We have never done an X-stop procedure. How should I report it, and what [...]
