Neurosurgery Coding Alert

Question: What is the best code to use for X STOP spinal stenosis surgery?

Minnesota Subscriber

Answer: The American Association of Neurological Surgeons recommends 0171T (Insertion of posterior spinous process distraction device [including necessary removal of bone or ligament for insertion and imaging guidance], lumbar; single level) because inserting an x stop still is considered an emerging technology. If your physician treats additional levels, add +0172T (... each additional level [List separately in addition to code for primary procedure]).

Include the appropriate diagnosis for spinal stenosis, such as 724.0x (Spinal stenosis, other than cervical). Neurosurgery Coding Alert/2009, Vol. 10, No. 13 To subscribe, call (800) 508-2582 Page  03 During x-stop spinal surgery, your physician inserts the implant through a small incision in the patient's back. He places the implant between the spinous processes of the lower vertebrae (which means you'll probably choose the best diagnosis from 724.0x). The x-stop is designed to remain permanently in place without attaching to bone or ligaments in the patient's back. Any image guidance your neurosurgeon uses for placement is considered bundled into the service.