CODING ~ Introduction Of 'T' Code A Good Sign For This Spinal Stenosis Treatment
Published on Mon Jan 01, 2007
Welcome these new category III codes for 'X Stop' procedures. January is a time to adjust to new and revised CPT codes, and neurosurgery practices will have a lot to digest this month -- thanks to the overflow of neurosurgery-related changes in the latest CPT manual.
The lowdown: One of the biggest changes for neurosurgery coders is that there is now a temporary code to represent X Stop procedures. Also, there are now permanent codes for a new nerve regeneration procedure.
These new codes took effect on Jan. 1, and CPT expects coders to start using them right away. Remember that there is no longer a grace period for you to get used to the new codes. Here's how to start out on the right track:
X Stop 'T' Codes Are Valid, But They're Not In CPT 2007
There are a pair of Category III (temporary, or "T") neurosurgery codes that did not make it into the print version of CPT 2007 but are valid starting Jan. 1, says Annette Grady, CPC, CPC-H, CPC-P, an independent coding consultant in North Dakota, member of the AAPC National Advisory Board, and senior orthopedic coder and compliance auditor for The Coding Network.
These codes refer to the surgeon's work placing an X Stop device to treat spinal stenosis using an interspinous process distraction (IPD) procedure. Previously, your only option was to report 22899 (Unlisted procedure, spine) to represent X Stop procedures. Now, reimbursement for the X Stop procedure is rare because many payors consider it investigational, but perhaps the introduction of the T code can show insurers that surgeons are performing it more frequently and may open up more reimbursement avenues.
Put these in your CPT book: We recommend that you put these two codes and their descriptors in your new manual so you don't forget to begin using them right away:
0171T (Insertion of posterior spinous process distraction device [including necessary removal of bone or ligament for insertion and imaging guidance], lumbar; single level)
0172T (... each additional level [list separately in addition to code for primary procedure] (use 0172T in conjunction with code 0171T).)
Bonus: Grady says that the addition of the X Stop codes is wonderful news for neurosurgeons because it means the X Stop is gaining acceptance. The assignment of a Category III code is often the first step toward a procedure's gaining permanent code status. "This is a very promising procedure for our elderly patients who suffer from spinal stenosis," she says. Experts contend that the X Stop is less invasive than a disk replacement, another procedure neurosurgeons perform for spinal stenosis patients.
Example: A patient with lumbar spinal stenosis reports to the neurosurgeon. The surgeon performs an X Stop on three levels. On the claim, you [...]
