Neurosurgery Coding Alert
Focus on Number of Treatment Days for Adhesiolysis
Question: My neurosurgeon performed an epidural lysis of adhesions using hypertonic saline. My neurosurgeon administered four injections during one day. He used a Racz catheter for this procedure, according to the medical documentation. Which CPT® code should I report? Nebraska Subscriber Answer: You should report 62264 (Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day) on your claim since the treatment lasted just one day. You should only report 62264 once for the entire series of injections, even though your neurosurgeon performed multiple injections. Always count the number of treatment days, not the number of adhesions when reporting adhesiolysis. As per its code descriptor, 62264 describes multiple adhesiolysis treatment sessions your neurosurgeon performs on the same day. Don’t miss: Although your neurosurgeon used a Racz catheter, you would still report 62264 on your claim because this term is “synonymously” used with the term “adhesiolysis.” During a Racz catheter procedure, an invasive method commonly adopted for attempting to relieve pain, your neurosurgeon will place a wire catheter through the patient’s tailbone and advance it into the caudal canal and the lumbar epidural space. Your neurosurgeon will then infuse an enzyme called hyaluronidase to break down the scar tissue. Your neurosurgeon will also infuse hypertonic saline through the catheter to provide relief from pain and facilitate dissolution of the adhesions. Following this, your neurosurgeon may use steroids. Coding tip: You should never report codes 62263 (Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days) and 62264 together on the same claim.
Neurosurgery Coding Alert
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