Know Neurofibromatosis Type Before Choosing Dx
Question: A patient reported to the neurosurgeon for an osteotomy of the thoracic spine to address their type 2 neurofibromatosis. The surgeon used anterior approach for the osteotomy, which they performed on a pair of thoracic segments, and also performed a discectomy during the procedure. How many CPT® codes should I report for this encounter, and could you tell me something about neurofibromatosis? West Virginia Subscriber Answer: You’ll report two codes for the osteotomy: 22222 (Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic) and +22226 (… each additional vertebral segment (List separately in addition to code for primary procedure)). You cannot report the discectomy separately because the 22222 descriptor covers it. Dx coding: You’ll also want to append Q85.02 (Neurofibromatosis, type 2) to 22222 and +22226 to represent the patient’s neurofibromatosis. There are two types of neurofibromatosis: type 1 (Q85.01 [Neurofibromatosis, type 1]), which is also called Von Recklinghausen disease; and type 2 (Q85.02), which is also called acoustic neurofibromatosis. According to Codify, “Neurofibromatosis, type 1 (NF1), is a genetic disorder characterized by the growth of noncancerous tumors along the nerves in the skin, brain, and other parts of the body.” Neurofibromatosis type 2 (NF2) also causes tumor formation on the nerves, but type 2 neurofibromatosis typically affects mainly the brain and spinal cord. Best bet: These two conditions are very similar, and it isn’t for the coder to make educated guesses. If the type isn’t specified as NF1 or NF2, query the provider about which type of neurofibromatosis the patient suffers from. Chris Boucher, MS, CPC, Senior Development Editor, AAPC
