Wiki Lumbar Coblations

[bdye]

Advise/Opinions Please.
I have a neurosurgeon who billed a 63056 for the coblation of L4-L5 and coblation of L5-S1. I am being advised that a better code of 62287 should have been billed for this procedure. Can anyone educate me on this procedure? According to op note, nothing was removed - no specimens.

Thanks,
bdye

 

[RebeccaWoodward*]

Typically, 62287 is performed for coblations.

62287: Percutaneous discectomy is done by any method to decompress the nucleus pulposus of a herniated lumbar intervertebral disc that may be pressing on nerve roots or the spinal cord, causing pain, disability, and loss of feeling. Percutaneous disc decompression is done for patients with a contained herniated disc that is bulging without rupture. Different percutaneous procedures include manual, automated, and laser methods. All types of procedures involve inserting small instruments between the vertebrae into the middle of the disc and using radiographic monitoring to guide the instruments as herniated tissue is removed. Laser instruments burn or evaporate the disc. One advanced method, called DISC nucleoplasty, uses special plasma technology, instead of heat energy, to remove the tissue from the center of the disc. A SpineWand is inserted through a needle into the center of the disc. A series of channels is made to remove tissue precisely and without trauma. As tissue is removed from the nucleus, the disc is decompressed and the pressure exerted on nearby nerve root is relieved. Use this code for percutaneous decompression of single or multiple lumbar levels.

Some carriers view this as experimental and do not allow reimbursement. I would check with your carrier in question to determine if they allow for this particular CPT code.


Nationally Non-Covered Indications
Effective for services performed on or after September 29, 2008, the Centers for Medicare and Medicaid Services has determined that TIPs are not reasonable and necessary for the treatment of low back pain. Therefore, TIPs, which include procedures that employ the use of a radiofrequency energy source or electrothermal energy to apply or create heat and/or disruption within the disc for the treatment of low back pain, are noncovered


http://www.cms.hhs.gov/Transmittals/downloads/R97NCD.pdf

 

[bdye]

Rebecca - Thank you so much for your reply. The transmittal that you referred me to was most helpful.

Betty