Pain Management Coding Alert

Question: What is intradiscal electrothermal anuloplasty (IDET)? Our physician provided radiological guidance for this procedure. How can we report this service?

Florida Subscriber

Answer: Although you don’t specify what type of radiological assistance your physician provided, IDET is usually done under fluoroscopic guidance. This type of guidance is bundled into codes 22526 (Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level) and +22527 (… 1 or more additional levels [List separately in addition to code for primary procedure]).

Report CT and MRI: You will separately report any other type of radiological guidance your physician used. For CT guidance, you submit code 77012 (Computed tomography guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], radiological supervision and interpretation) and for MRI, you submit code 77021 (Magnetic resonance guidance for needle placement [e.g., for biopsy, needle aspiration, injection, or placement of localization device] radiological supervision and interpretation).

Understand the procedure: Intradiscal electrothermal annuloplasty (IDET) is a procedure where your physician adopts a percutaneous approach to place a specialized wire into the intervertebral disc. This helps to firm up and stabilize the annulus fibrosa.

Check these codes: You report code 22526 for the first level of IDET. For any additional levels, you submit the add-on code +22527. You report only one unit of code +22527 irrespective of how many additional levels your physician treated after the initial one.