Anesthesia Coding Alert

Question: Coders in our office disagree on the best code for an anterior approach Racz procedure. What is the best option?

South Carolina Subscriber
  
Answer: The Racz procedure (named after the physician who first performed it) is known by several other names, including epidural neuroplasty, epidural neurolysis or epidural lysis of adhesions. Coders -- and carriers -- have differing opinions on how to report the service, if at all.

Many carriers consider Racz an experimental procedure, which means they won't reimburse for the service. A few carriers (such as Blue Cross/Blue Shield in North Carolina) recommend reporting 62264 (Percutaneous lysis of epidural adhesions using solution injection [e.g., hypertonic saline, enzyme] or mechanical means [e.g., catheter] including radiologic localization [includes contrast when administered], multiple adhesiolysis sessions; 1 day).
 
Some coders opt for 62263 (... 2 or more days) for longer-lasting treatment or 62281 (Injection/infusion of neurolytic substance [e.g., alcohol, phenol, iced saline solutions], with or without other therapeutic substance; epidural, cervical or thoracic).

Bottom line: Always get pre-approval before scheduling a Racz procedure or make payment arrangements with the patient. If you do submit a claim, verify the carrier's preferred code before filing. 

Answers to You Be the Coder and Reader Questions were reviewed by Terry Celestino, CPC, a coder with Northwest Anesthesiology in San Antonio.