CPT changes to pain management procedure codes
In 2011, the AMA revised thetransforaminal dpidural steroid injection codes to include the use of imaging (fluoroscopy or CT) and imaging used in the procedure, making the imaging no longer separately billable with code 77003-TC, as it was previously in 2010.
For 2012, the AMA is now doing the same thing with the epidural steroid injection (ESI) CPT codes 62310 (cervical or thoracic ESI), 62311 (lumbar or sacral ESI), 62318 (cervical or thoracic by continuous infusion) and 62319 (lumbar or sacral) by continuous infusion). These four codes now include the contrast for localization, when it is used in the ESI procedures, making the use of contrast no longer separately billable with radiology code 77003.
On spinal cord neurostimulator codes, some minor revisions have been made to the CPT codes, as follows:
Code 64561 for the percutaneous implantation of neurostimulator electrode array of the sacral nerve (transforaminal placement) for an InterStim used for an overactive bladder (which is usually used for stage I trial procedures) has been revised to add the word "array (electrode array) instead of just electrode. CPT instructs to use new Category III codes 0282T-0284T when implanting trial or permanent electrode arrays or pulse generators to be used for peripheral subcutaneous field stimulation procedures.
The same change was made to code 64581 for incision for implantation of neurostimulator electrode array of the sacral nerve (transforaminal placement) for the stage II permanent InterStim procedure, where the word "array" was added to the code descriptor.
Code 64585 for the revision or removal of a peripheral neurostimulator electrode array also added the word "array" to the code descriptor. There was no change to the code for the implantation of the generator used in the permanent procedure.
Codes for Radiofrequency procedures on Facet Joints have changed for 2012 in the CPT book. The following codes have been deleted for 2012:
Code 64622 for destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, single level has been deleted.
Add-on code 64623 for destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, each additional level (list separately in addition to code for primary procedure) has been deleted.
Code 64626 for destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level has been deleted.
Add-on code 64627 for destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, each additional level (list separately in addition to code for primary procedure) has been deleted.
These four codes have been replaced by the following new CPT codes for 2012:
Use code 64633 for the destruction of paravertebral facet joint nerve(s) by neurolytic agent with fluoroscopy or CT image guidance; cervical or thoracic, single facet joint for the first level performed. The add-on code for additional levels is code 64634.
Use code 64635 for the destruction of paravertebral facet joint nerve(s) by neurolytic agent with fluoroscopy or CT image guidance; lumbar or sacral, single facet joint for the first level performed. The add-on code for additional levels is code 64636.
CPT code 77003 for fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) was revised for 2012. The words "( or sacroiliac joint), including neurolytic agent destruction" were eliminated from the coding descriptor for this code.
In 2011, the AMA revised thetransforaminal dpidural steroid injection codes to include the use of imaging (fluoroscopy or CT) and imaging used in the procedure, making the imaging no longer separately billable with code 77003-TC, as it was previously in 2010.
For 2012, the AMA is now doing the same thing with the epidural steroid injection (ESI) CPT codes 62310 (cervical or thoracic ESI), 62311 (lumbar or sacral ESI), 62318 (cervical or thoracic by continuous infusion) and 62319 (lumbar or sacral) by continuous infusion). These four codes now include the contrast for localization, when it is used in the ESI procedures, making the use of contrast no longer separately billable with radiology code 77003.
On spinal cord neurostimulator codes, some minor revisions have been made to the CPT codes, as follows:
Code 64561 for the percutaneous implantation of neurostimulator electrode array of the sacral nerve (transforaminal placement) for an InterStim used for an overactive bladder (which is usually used for stage I trial procedures) has been revised to add the word "array (electrode array) instead of just electrode. CPT instructs to use new Category III codes 0282T-0284T when implanting trial or permanent electrode arrays or pulse generators to be used for peripheral subcutaneous field stimulation procedures.
The same change was made to code 64581 for incision for implantation of neurostimulator electrode array of the sacral nerve (transforaminal placement) for the stage II permanent InterStim procedure, where the word "array" was added to the code descriptor.
Code 64585 for the revision or removal of a peripheral neurostimulator electrode array also added the word "array" to the code descriptor. There was no change to the code for the implantation of the generator used in the permanent procedure.
Codes for Radiofrequency procedures on Facet Joints have changed for 2012 in the CPT book. The following codes have been deleted for 2012:
Code 64622 for destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, single level has been deleted.
Add-on code 64623 for destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, each additional level (list separately in addition to code for primary procedure) has been deleted.
Code 64626 for destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level has been deleted.
Add-on code 64627 for destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, each additional level (list separately in addition to code for primary procedure) has been deleted.
These four codes have been replaced by the following new CPT codes for 2012:
Use code 64633 for the destruction of paravertebral facet joint nerve(s) by neurolytic agent with fluoroscopy or CT image guidance; cervical or thoracic, single facet joint for the first level performed. The add-on code for additional levels is code 64634.
Use code 64635 for the destruction of paravertebral facet joint nerve(s) by neurolytic agent with fluoroscopy or CT image guidance; lumbar or sacral, single facet joint for the first level performed. The add-on code for additional levels is code 64636.
CPT code 77003 for fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) was revised for 2012. The words "( or sacroiliac joint), including neurolytic agent destruction" were eliminated from the coding descriptor for this code.
