I didn't mention 0232T because of the following statement from CPT Assistant.
"The intent of code 0232T is that it should not be reported for use of platelet rich plasma in procedures performed on the spine. "
October 2012 page 14
Frequently Asked Questions:Anesthesia: Other Procedures
Question: A patient with a diagnosis of cervical disc disease, broad based posterior disc bulge at C3-C4, and radiculopathy of left upper extremity undergoes the following procedure performed by one primary surgeon and one assistant surgeon: A spinal needle was inserted into the disc space at C3-C4. This was confirmed on fluoroscopic views. The discogram was performed using indigo carmine dye mixed with radiotracer dye in order to stain the disc material blue so as to differentiate it from the surrounding neural elements. A guidewire was placed through the spinal needle and the spinal needle was extracted. This was once again confirmed with fluoroscopy. Sequential dilators were placed over the guidewire. An endoscope was inserted after the final dilator was placed with the working tube. The disc space was inspected. Microdiscectomy was performed. This was carried back to the annulus. The incision was irrigated well. Platelet-rich plasma gel which was harvested at the start of the case via peripheral blood drawn and prepped on the back table via centrifuge was placed into the surgical wound. The wound was closed and sterile dressings were applied. The patient was then placed into a cervical collar. May codes 62287 and 0232T be reported with modifier 62, Two Surgeons, appended?
Answer: No. There is no specific code for the described procedures when performed in the cervical region. Therefore, code 64499, Unlisted procedure, nervous system, should be reported once by each physician. It would not be appropriate for either surgeon to report code 62287, Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with the use of an endoscope, with discography and/or epidural injection(s) at the treated level(s), when performed, single or multiple levels, lumbar, as this describes work performed only in the lumbar (not cervical) spinal region. Also, Category III code 0232T, Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed, is not reportable for this procedure performed in the spinal region. The intent of code 0232T is that it should not be reported for use of platelet rich plasma in procedures performed on the spine.
Neither modifier 80, Assistant Surgeon, nor modifier 62 should be appended to code 64499. Because unlisted codes do not include descriptor language that specifies the components of a particular service, these codes are reported without modifiers. Modifiers are used to indicate that a service or procedure performed was altered by some specific circumstance, but not changed in its definition or code. Because unlisted codes do not include descriptor language that specifies the components of a particular service, there is no need to "alter" the meaning of the code. Since the unlisted procedure code is being reported, documentation should be submitted describing the procedure performed.
