Neurosurgery Coding Alert

Question: What is intradiscal electrothermal anuloplasty (IDET), and how can we report this procedure?

Florida Subscriber

Answer: Since your physician is using an electrothermal technique for annuloplasty, you report code 22526 (Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level) for the first level of IDET. For any additional levels, you submit the add-on code +22527 (Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels [List separately in addition to code for primary procedure]).

Remember: You report only one unit of code +22527 irrespective of how many additional levels your physician treated after the initial one.

Tip: If however, your surgeon did the annuloplasty using a different technique, you would submit the unlisted procedure code 22899 (Unlisted procedure, spine).

Do not forget that imaging is included: IDET is usually done under fluoroscopic guidance. This type of guidance is bundled into codes 22526 and +22527. 

What is intradiscal electrothermal annuloplasty? Intradiscal electrothermal annuloplasty (IDET) is a procedure where you physician adopts a percutaneous approach to place a specialized wire into the intervertebral disc and use an electrothermal energy source to alter the annular collagen. This may help to firm up and stabilize the annulus fibrosa as well as damage pain fibers in the annulus.