Neurosurgery Coding Alert

Question: Recently, I filed a claim for intradiskal electrothermal therapy (IDET) using unlisted-procedure code 64999, but my claim came back without payment. Should I be using a different code?


Connecticut Subscriber

Answer: Yes, you are using the wrong code to report IDET. Since July 1, 2004, there have been two Category III CPT codes you should use for IDET:

- 0062T--Percutaneous intradiskal annuloplasty, any method, unilateral or bilateral including fluoroscopic guidance; single level

- +0063T--Percutaneous intradiskal annuloplasty, any method, unilateral or bilateral including fluoroscopic guidance; one or more additional levels (list separately in addition to 0062T for primary procedure).

Old way: Prior to July 2004, you would have been correct to report 64999 (Unlisted procedure, nervous system) with most payers.

New way: Now you should only use 64999 if your carrier specifically states that it won't accept Category III codes. Use 0062T and 0063T now.

Note: Many insurers, including Medicare, consider IDET experimental and will not pay for the procedure at all. If you include documentation from your neurosurgeon explaining the medical necessity for the procedure, you-ll increase your chances of seeing reimbursement from some carriers.

You might use diagnosis codes such as 724.2 (Lumbago), 722.73 (Intervertebral disk disorder with myelopathy; lumbar region), 722.10-722.11 (Displacement of thoracic or lumbar intervertebral disk without myelopathy), and 724.3 (Sciatica).