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Neurology & Pain Management Coding Alert

Reader Questions:

Resort to 'Unlisted' for MILD Procedure

Published on Wed May 11, 2011

Question: What is the best CPT® code for minimally invasive lumbar decompression (MILD)?Colorado SubscriberAnswer: CPT® does not include a code specifically for MILD, so you'll choose between two 'unlisted' codes: 22899 (Unlisted procedure, spine) or 64999 (Unlisted procedure, nervous system).Coders sometimes ask if 63030 (Laminotomy [hemilaminectomy], with decompression of nerve root[s], including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, including open and endoscopically-assisted approaches; 1 interspace, lumbar) can be used for MILD. The answer is no because of the difference in what MILD represents and the descriptor for 63030. The MILD procedure is a fluoroscopically guided needle-based approach without direct visualization of the neural structures and is not intended for removal of disc material. Code 63030, by contrast, represents an open surgical or open with endoscopic-assisted approach.Looking ahead: A new Category III code that could apply to the MILD procedure will go into effect July 1, 2011 and [...]
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