Neurology & Pain Management Coding Alert

Amid all the changes for 2005 comes some comforting news: Improved reimbursement for fluoroscopic guidance with paraspinal injections and a stress-free transition for ICD-9 coding in neurology practices.

Good news if your neurologist uses fluoroscopic guidance: Aetna has reversed its policy of denying fluoroscopic guidance when you report the service with spinal and paraspinal injections (such as 64470-64476) effective Aug. 15, 2004. The carrier now reimburses for 76005 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint], including neurolytic agent destruction) during these injection procedures.

Expect an easy transition to ICD-9 2005: The 2005 ICD-9 manuals are available now, and neurology coders and practitioners shouldn't have too much trouble transitioning when all-new 2005 ICD-9 codes become effective Oct. 1, 2004. Aside from new diagnoses for stroke (see Neurology Coding Alert, September 2004) and narcolepsy (Neurology Coding Alert, August 2004), changes to ICD-9 for 2005 will have little effect on neurology practices. You can view the complete list of additions and revisions for ICD-9 2005 at www.cms.hhs.gov/medlearn/icd9code.asp#coding.