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Editor's Note: This article by Paul Cadorette, director of education for mdStrategies, originally appeared in The Coding Advocate, mdStrategies free monthly newsletter. Sign-up to receive this newsletter by clicking here.
1. The transforaminal injection codes have been revised and now take on the same look as the facet injection codes. Image guidance (fluoroscopy or CT) is required when performing the injection procedure, but the CPT code definitions for 64479-64484 now include fluoroscopic or CT imaging as an inclusive component of the procedure, so 77003 is no longer reported for fluoroscopy in addition to the transforaminal CPT code.
2. Category III codes should be reported when transforaminal or facet injections are performed using ultrasound guidance.
3. Epidural, transforaminal or facet injection(s) performed at theT12-L1 interspace/facet would be reported with the appropriate CPT code for the cervical or thoracic level and not a code from the lumbar or sacral level series of codes.
4. There are three new codes for both the hip arthroscopy (femoroplasty, acetabuloplasty, labral repair) and endoscopic balloon dilation of the sinuses (maxillary, frontal, sphenoid). For those ASC’s performing spinal arthrodesis procedures, you should note that a threaded bone dowel (previously reported as a biomechanical device) is now considered a structural bone allograft and a discectomy for decompression of the spinal cord and/or nerve roots is included in an anterior interbody technique (CPT code 22551) so code 63075 will no longer be additionally reported.
The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.