Anesthesia Coding Alert

At first glance, one bright spot in Correct Coding Initiative (CCI) version 15.3 could be the list of terminated code pairs, especially if your pain management provider performs IDET -- but don't get too excited too soon.

The report terminates many previous coding pair edits associated with code 22526 (Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level) including:

• Many somatic nerve injection procedures (64400- 64483)

• All sympathetic nerve injections (64505-64530)

• Transesophageal echocardiography monitoring (93318, Echocardiography, transesophageal [TEE] for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing [continuous] assessment of [dynamically changing] cardiac pumping function and to therapeutic measures on an immediate time basis).

CCI 15.3 indicates that you can code for these paired procedures retroactive to April 1, 2009 -- but there's a catch.

"Thermal intradiscal procedures, including IDET, are non-covered effective Sept. 28, 2008, based on a Medicare National Coverage Determination (NCD) policy," says Marvel J. Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, owner of MJH Consulting in Denver. "It isn't necessary to have CCI edits if the Column 1 code is not covered, so the bundling edit deletions make sense."