Code for New IDET Procedure to Get Best Reimbursement
Published on Fri Sep 01, 2000
The Federal Drug Administration (FDA) cleared IntraDiscal Electrothermal Therapy (IDET) in 1998 to treat patients with chronic diskogenic pain, but many insurance carriers are still unfamiliar with it. There is no CPT Codes for the procedure, and this adds to the challenge anesthesia providers face when attempting to get reimbursed. Practices that work with their local carriers to gain preapproval for the procedure and understand the accepted codes for it will have a more successful reimbursement track record.
What Leads to IDET?
Tears or fissures may develop in the walls of intervertebral disks as you age. These tears can become a source of chronic pain. The inner disk tissue sometimes can herniate into the fissures, which stimulate pain sensors in the disk and add to the patients discomfort.
Before doing an IDET procedure, the patient must be diagnosed with diskogenic pain (722.0-722.9). For example, a patient may have low back pain for months or years that radiates into his buttocks or tailbone but with very little radiation down the leg. In time, the patients physician may decide to take the next step to determine whether he has diskogenic pain.
The next step toward that diagnosis is a magnetic resonance imaging (MRI) performed by a radiologist. These codes are 72148-72149 and 72156-72158. The MRI shows whether the disk has signs of wear and tear or degenerative changes. Disks that cause pain usually show a loss of water content, and the radiologist may find a tear in the disk or other evidence of damage during the MRI.
If the MRI shows changes in the disk, physicians possibly would prescribe physical therapy, depending on how severe the patients pain is and how damaged the disk is. A series of pain management injections (20550, 64475, 64476, 64483, 64484, 62280, 62282, 62311) also may be prescribed before taking the patients treatment to the next level.
If these conservative therapies dont help the patients pain, the physician will perform diskography, which is recognized as the gold standard for making a disk-related diagnosis. A needle is placed in the patients disk by an anesthesiologist or neurosurgeon, and physiological pressure is created to represent the actual tension the disk is under when the patient is sitting or standing. Dye is injected during the test that fills cracks and allows the physician to see tears in the disk.
Cecelia McWhorter, BA, CPC, a coder with the physician billing agency Comp One Services Ltd. in Oklahoma City, says the injection procedure for diskography should be billed using either code 62310 (injection, single [not via indwelling catheter], not including neurolytic [...]
