Neurosurgery Coding Alert

Question: We have never done an X-stop procedure. How should I report it, and what is the reimbursement like? New Mexico Subscriber Answer: You should report your surgeon's services with the following T codes: - 0171T - Insertion of posterior spinous process distraction device (including necessary removal of bone or ligament for insertion and imaging guidance),lumbar; single level - +0172T -- ... each additional level (List separately in addition to code for primary procedure) (use 0172T in conjunction with code 0171T). Some coders report approximately $400 in reimbursement from Medicare, the only carrier who is paying for this procedure. Check your payer guidelines. CPT instructions are clear on the use of Category III codes -- report them whenever available. Because coverage and reimbursement remains a payer decision, you should follow the same process with reporting Category III codes as you do with unlisted procedure Category I codes. With Category III codes, you-re not [...]