Leorah Posted Fri 22nd of May, 2020 05:29:24 AM
Our Dr. performed a lumbar puncture under flouroscopy with injection of intrathecal contrast. We coded this procedure with a 62284 and 77003. The insurance company is now saying that they are recouping the payment for the 77003 since this treatment is considered experimental. We have used this code before many times. Is there was a change recently or should I be coding this differently? I used ICD-10 M48.02. Thank you
SuperCoder Answered Tue 26th of May, 2020 10:04:26 AM
As per the above-mentioned documentation, physician has performed the procedure on lumbar region i.e. 62284 but the diagnosis given by physician is for cervical region i.e. M48.02. ICD-10 M48.02 is not appropriate diagnosis code for CPT 62284 because of the different anatomical region. So, it is suggested please check your documentation properly for correct ICD-10 code; and then code accordingly.
Hope this helps!
Leorah Posted Sun 31st of May, 2020 04:08:58 AM
If coded with M48.061which is the lumbar region should the 77003 been paid?
SuperCoder Answered Mon 01st of June, 2020 05:36:41 AM
Thanks for the query.
As per the CPT guidelines, if physician has performed 62284 under fluoroscopic guidance then CPT 77003 also be coded for fluoroscopic guidance. ICD M48.061 is the appropriate code for CPT 62284 and 77003 and will get reimbursed.