Neurosurgery Coding Alert

Report the other pain management procedure -- sometimes.The latest version of Correct Coding Initiative (CCI) edits went into effect Oct. 1, and introduced a slew of pairings involving new Category III "T" codes for transforaminal epidural injections:0228T -- Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, cervical or thoracic; single level0229T -- ... each additional level (List separately in addition to code for primary procedure)0230T -- Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, lumbar or sacral; single level0231T -- ...... each additional level (List separately in addition to code for primary procedure)."Although the primary procedures have been performed for years as Category I codes, the guidance method has been fluoroscopic or CT-guided," says Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison. "Since the efficacy and accuracy of ultrasound guidance has not been comparatively validated, Category III codes were developed for transforaminal epidural [...]