Anesthesia Coding Alert

Question: I am having trouble with workers'-compensation and auto-insurance companies regarding diskogram reimbursement. They are adding modifier -51 (multiple procedures) to my additional levels and reducing my payment by half.

When I appealed their payment, I was informed that the procedure code for diskogram was not on the list of CPT codes exempt from modifier -51. I have been able to overturn a couple of claims and receive payment, but I have to go to a mediation hearing to fight for payment on five claims. Is there any written documentation I can use in this fight?

Connecticut Subscriber
Answer: There are two procedures involved here diskography and diskogram and it is very easy to confuse the two. Diskography refers to the injection of dye and is reported using either 62290* (injection procedure for diskography, each level; lumbar) or 62291* ( cervical or thoracic), depending on whether the cervical or lumbar region received the injection. Both procedures are surgical, which means multiple procedure rules apply.

Diskography is performed so that a diskogram can be obtained. The diskogram is a supervision and interpretation (S&I) report that is billed using 72285 (diskography, cervical or thoracic, radiological supervision and interpretation).

Because it is a radiology code, multiple surgical rules do not apply and the service is billed at 100 percent of the fee schedule even if multiple diskograms are performed.