Neurosurgery Coding Alert

Effective April 1, thoracic CAT scan codes 72128, 72129 and 72130 are bundled into thoracic percutaneous vertebroplasty codes 22520 and 22521. Code 22520 is the comprehensive code, and CAT scan codes 72128-72130 are components. Also, 22521 is the comprehensive code, and CAT scan codes 72131-72133 are components. These codes are listed with the identifying code of 1, which means modifier -59 (distinct procedural service) can be used to bill them separately provided all the criteria for using this modifier have been met. Other radiological guidance and supervision codes (76012-76013) may still be used with percutaneous vertebroplasty.

Additional revisions dictate that injection procedures (20550) are now considered integral to many nerve block procedures in the 64400-64450 code range.

The following are the comprehensive codes that include component code 20550: 64400*, 64402*, 66412*, 64413*, 64415*, 64417*, 64418*, 64420*, 64421*, 64425*, 64430*, 64445*, 64470, 64475, 64479 and 64483.

These codes are listed with the identifying code of 1, which means modifier -59 can be used to bill them separately provided all the criteria have been met.

The following codes in this range were not made comprehensive for 20550: 64405*, 64408*, 64410*, 64435* and 64450.*

Note: 64450* is already bundled with 20550, but as a component.

The following add-on/additional level codes were also not directly made comprehensive codes to 20550; however, they can only be billed with primary codes that were made comprehensive to 20550: +64472, +64476, +64480, +64484.