Neurosurgery Coding Alert
Base Block Coding on Levels, Not Nerves
Question: Our surgeon documented that he administered a nerve block to the left side of C3 through C7. How many levels do we consider this when coding? Will we have to apply modifiers for multiple units? Pennsylvania Subscriber Answer: You should base your coding on the facet joint level, rather than the individual nerves, that the surgeon treats. Facet joint nerves C3 and C4 innervate the C3-C4 facet joint. So you would report a nerve block to this joint with 64470 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; cervical or thoracic, single level). The C4 and C5 facet joint nerves innervate the C4-C5 facet joint, the C5 and C6 facet joint nerves innervate the C5-C6 facet joint, and the C6 and C7 facet joint nerves innervate the C6-C7 facet joint. Report blocks to each of these facet joints using +64472 (- cervical or thoracic, each additional level [list separately in addition to code for primary procedure]). Your final claim should include 64470 once, plus three units of 64472.
Neurosurgery Coding Alert
- Distinguish Spinal '-ectomies' for Easy Coding:
Here's How
Hint: Purpose of the surgery can help you narrow your selection Similarities among vertebral corpectomy, [...] - New ABN Will Free You From NEMB Confusion
Update now if you-re not already using the revised form If you never quite understood [...] - IOM 101:
There's More to It Than 95920
Tracking time, reporting baselines present the real challenge You-re not alone if you find yourself [...] - You Be the Coder:
Base Block Coding on Levels, Not Nerves
Question: Our surgeon documented that he administered a nerve block to the left side of [...] - Reader Questions:
Halo Removal Included in Placement
Question: May we report 20665 for removal of a stereotactic halo? Ohio Subscriber Answer: The [...] - Reader Questions:
Bilateral Laminectomy Doesn't Require Modifier 50
Question: Should we append modifier 50 for a bilateral lumbar laminectomy? Washington Subscriber Answer: As [...] - Reader Questions:
Pain Pump May Be Separate
Question: How should I report pain pump application following surgery? North Carolina Subscriber Answer: In [...] - Reader Questions:
Snag Separate PLIF and Laminectomy Pay
Question: My surgeon argues that we should be able to report a laminectomy (63047) in [...] - Reader Questions:
'Simple' Denotes Size or Complexity for Aneurysm
Question: What differentiates a "simple" from a "complex" intracranial aneurysm? Mississippi Subscriber Answer: Codes 61697 [...]
