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Old 04-11-2011, 09:42 AM
mattamyc mattamyc is offline
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Default Lumbar Disc Displacement with Radiculopathy

I am having trouble with this coding. The op report states the following diagnosis
1. Lumbar Disc Displacement
2. Lumbar Radiculopthy

CPT 722.10 states it includes radiculititis due to displacement and CPT 724.4 excludes 722.0-722.9

It is correct to code ONLY 722.10 since the operative report only gives these 2 conditions and no other cause of the Radiculopathy?
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Old 04-12-2011, 09:22 AM
dwaldman dwaldman is offline
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This is a situation where the doctor would have to be made aware that if the radiculopathy is "attributable to the herniated disc" that he needs to describe in the Dx section as for example

Radiculopathy due to lumbar disc protrusion

If the physician is not aware of the coding options with this he probally will continue to not state the relation of the symptom and the condition. I think you could query the physician but by going by the 1994 AHA Coding Clinic example it sounds it there is not a correlation made you could potentially bill both 722.10 and 724.4.


As seen below it states in the AHA Coding Clinic in 1994

".......Lumbar spinal stenosis, since the physician has stated that the lumbar stenosis is not attributable to the herniated disc."

This is a clarification of the information that was previously published inCoding Clinic, Second Quarter 1989,p. 14.





__________________________________________________ ___________________


Volume: 1989

Issue: Second

Title: Excludes notes under diagnosis codes 723 and 724

Body: Question:

Please clarify the"Excludes" notes under 723 and 724.Do these "Excludes" notes mean that conditions due to intervertebral disc disorders or spondylosis are included in codes 721.0--722.9 or do both conditions need to be coded?

Answer:

Symptoms and signs associated with (due to) spondylosis and allied disorders, 721.0--721.91, or intervertebral disc disorders (such as slipped disc or arthritic degeneration of intervertebral disc), 722.0--722.93, are included in the 721--722 code series.

Examples

• Sciatica, 724.3, due to a slipped or degenerative intervertebral disc is included in the 722 category.

• Pain or neuritis due to spondylosis or intervertebral disc disorder is included in the 721--722 categories.

• Spinal stenosis due to degeneration (arthritic) of the intervertebral disc is classified to the 722 category, while spinal stenosis, congenital or NOS, is classified within the 723--724 categories.

__________________________________________________ ______________________

Volume: 1994

Issue: Third

Title: Clarification - excludes notes under categories 723/724

Body: Clarification of Excludes Notes under categories 723 and 724

Question:

A patient is admitted for surgical therapy because of chronic low back pain, which is presumed secondary to herniated intervertebral disc. A lumbar myelogram reveals lumbar disc herniation without myelopathy and lumbar spinal stenosis. The physician is queried and states, "The lumbar spinal stenosis is due to bony impingement." However, the physician denies the presence of spondylosis and cannot determine whether the spinal stenosis is congenital or acquired. Since the lumbar spinal stenosis is not attributable to the herniated disc, although it is an associated finding, is it appropriate to assign two codes 722.10, Displacement of lumbar intervertebral disc without myelopathy, and 724.02, Lumbar spinal stenosis?

Answer:

Assign code 722.10, Displacement of lumbar inter-vertebral disc without myelopathy, and code 724.02, Lumbar spinal stenosis, since the physician has stated that the lumbar stenosis is not attributable to the herniated disc.

This is a clarification of the information that was previously published inCoding Clinic, Second Quarter 1989,p. 14.
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Old 04-12-2011, 01:27 PM
mattamyc mattamyc is offline
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Thank you for the additional information - a great help!
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