Does anyone know if there is a specific code for this procedure, or do I need to do some creative coding?
Coding for therapeutic coccygeal intradiscal injection
- Thread starter knoxdoc
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20552 would be most appropriate.
Did you use fluoro and contrast?
Did you pass through the sacrococcygeal ligament?
If so: Ganglion Impar block (Walther) 64520
If not, could bill for ligament injection NOS.
If you could document a disc at this location via MRI and did a decompression of this disc you could submit 62287.
You could getpaif for the trigger point or the sympathetic block, but not both, and not the PDD.
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I would need more detail on how you performed this procedure to code accurately.
Did you inject the sacrococcygeal joint, or a non-fused remnant disk in the coccyx itself?
20550 for a ligament injection is a possibility, but it sounds like you did a sacrococcygeal joint injection, in which case you could use 20605 (intermediate size joint injection), which pays about the same. Depending on the carrier, you could try asking for more money with a 64999 (unlisted code), if you have a good staff that will follow up on this.
It does not sound like you did a muscular injection, so I would NOT use 20552. Also sounds like much more work than a 20552, and you don't want to short change yourself. From a compliance perspective, if your intention was not to do a sympathetic block, then I would not code it 64520.
The CPT Assistant Archive is a wonderful resource for coding questions and is around $300 per year. Cheaper for AMA members. You can order back issues of the newsletter as well to have documentation to send to insurance companies when they try to down code you.
http://www.ama-assn.org/
Another great resource for AMA members is to be able to ask 5 free coding questions per year. You type your question with as much detail as possible and someone from the AMA writes you back an answer within 14 days. Then you put a copy in your Compliance folder and refer to it if anyone questions your coding.
Thanks for all the input. I used flouro and contrast, but did not pass through the sacrococcygeal ligament. I was injecting a painful, non-fused remnant disc in the coccyx, so I will probably end up coding for an intermediate joint injection.
Should I try billing for disco?
Should I try billing for disco?
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Should I try billing for disco?
Discogenic pain as a cause of coccydynia. What a great concept! I knew those 3T MRIs would be good for something - detecting annular tears at S5/Co1.
"Opening pressure was 20 psi. Concordant pain with 0.1 cc of contrast. Free flow of contrast into the ganglion impar. Probable chemically-sensitive disk. Patient sent for post-injection CT."
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Wow is this thread old.
I wonder if any one will see my 2 cents?
lol
ok...20605 will only work with a rt, lt or bi modifier present.
I ran across this injection recently and have yet to find a payable way to code it.
Right now I am sort of leaning to code it by which side the physician was standing on when the injection was introduced.
It's a tough one. If any one else would care to contribute I would love to hear your input.
I wonder if any one will see my 2 cents?
lol
ok...20605 will only work with a rt, lt or bi modifier present.
I ran across this injection recently and have yet to find a payable way to code it.
Right now I am sort of leaning to code it by which side the physician was standing on when the injection was introduced.
It's a tough one. If any one else would care to contribute I would love to hear your input.
