Wiki Seperate procedures

[LaVoncye]

Please help: I am looking at a operative report, I am confused as hoe to code it please help

Per the Procedures
1. Provocative lumbar diskography L3-4, L4-5, L5-S1 under fluoroscopy
2. Lumbar diskogram
3.Fluoroscopuc guidance
4. Left L3, L4, L5 selective nerve root block under fluoroscopy

This is a Medicaid HMO insurance

Please help.

 

[dwaldman]

30. If the injection procedure for discography (CPT codes 62290, 62291) is followed by postoperative pain, treatment of this pain is not separately reportable (e.g., CPT codes 62310, 62311). The injection procedure codes have a global surgical indicator of 000 days. Medicare Global Surgery Rules include treatment of postoperative pain in the global surgical package.

Above is found in Chapter 8 of the NCCI policy manual. In your particular Scenario, you have selective nerve root block which is appears to be at three separate levels. But at the same level as 62290 injection for discography. NCCI has bundled the selective nerve root block.
Since selective nerve root block is not at separate levels nor a separate patient encounter, my interpretation is you would only report given the procedure report supports a 3 level discogram with interpretation of disc pathology:
62290 x3
72295 x3