Orthopedic Coding Alert

Question: Recently, I filed a claim for intradiskal electrothermal therapy (IDET) using unlisted-procedure code 64999, but my claim came back without payment. Should I be using a different code?


Connecticut Subscriber

Answer: Yes, you are using the wrong code to report IDET. Effective July 1, 2004, you should report one of two Category III CPT codes for IDET:

- 0062T--Percutaneous intradiskal annuloplasty, any method, unilateral or bilateral including fluoroscopic guidance; single level

- +0063T--... one or more additional levels (list separately in addition to 0062T for primary procedure).

Old way: Prior to July 2004, you would have been correct to report 64999 (Unlisted procedure, nervous system) to most payers.

New way: Now you should only use codes 0062T and 0063T.

Note: A few payers may still specifically require you to report 64999 because they don't accept Category III codes. But unless you have such direction in writing, stick with the -T- codes.

And many insurers, including Medicare, consider IDET experimental and will not pay for the procedure at all. If you include documentation from your surgeon explaining the medical necessity for the procedure, you-ll increase your chances of seeing reimbursement from some insurers.

You might use diagnosis codes such as 724.2 (Lumbago), 722.73 (Intervertebral disk disorder with myelopathy; lumbar region), 722.10-722.11 (Displacement of thoracic or lumbar intervertebral disk without myelopathy), and 724.3 (Sciatica).