Health Information Management

Tip: Corrrectly code image-guided lumbar decompression

APCs Insider, January 20, 2012

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Percutaneous image-guided, minimally invasive lumbar decompression witha specially designed toolkit (mildtm) has been proposed as an ultra-minimally invasive treatment for central lumbar spinal stenosis.

During this procedure, physicians fill the epidural space with contrast medium under fluoroscopic guidance. Using a 6-gauge cannula clamped in place with aback plate, physicians employ single-use tools (e.g., portal cannula, surgical guide, bone rongeur, tissue sculpter, and trocar) to resect thickened ligamentum flavum and small pieces of lamina. Tissue and bone sculpting occurs entirely under fluoroscopic guidance, with additional contrast media added throughout the procedure to aid visualization of the decompression. The process is repeated on the opposite side for bilateral decompression of the central canal.

Report CPT® category III code 0275T (percutaneous laminotomy/laminectomy [intralaminar approach] for decompression of neural elements) that became effective July 1, 2011, to denote this procedure. This code maps to APC 0280 with a national payment of $3,535.92. Note, however, that automatic CMS coverage is not implied simply because a CPT code with payment exists under OPPS.

The tip is adapted from “This month’s coding Q&A” in the January issue of Briefings on APCs.



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