Eli's Rehab Report

Question: Can a physiatrist perform a diskography at the same time as intradiskal electrothermal therapy (IDET) and still be reimbursed?

Virginia Subscriber
 
Answer: Yes. Based on a current NCCI version 10.3 edit, these two codes are not bundled (either as component or mutually exclusive). However, you need to clarify a few points.

First, identify the anatomic location and the reason the provider performed the diskography procedure.

If the physiatrist performed the diskography at a different level from the IDET (such as diskography at C2-C3, and IDET at L4-L5), you could add modifier -59 (Distinct procedural service) to the diskography code and send notes.

Although the claim probably won't process through initially, you can appeal the denial and probably get paid.

If the physiatrist performed the diskography at the same level, he most likely performed it first diagnostically to determine the need for a therapeutic procedure. Then he went ahead with the therapeutic IDET. You should still add modifier -59, but expect this to be more problematic for payment.

Ask yourself, did the physiatrist officially perform the diskography prior to the IDET? Or did the provider merely inject some contrast into the disk to verify the IDET electrode placement?

If so, the physiatrist did not perform a diskography diagnostic procedure (used for determination of morphology of an intervertebral disk/determination of patient's pain generators). You should not report these codes separately.