Ms. Pinky Maniri Consulting Group

Ms. Pinky Maniri Consulting Group
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Maximize Your Reimbursement for Discography

Discography is a procedure that is mainly done for diagnostic purposes and not for a therapeutic purpose. Remember that you are doing per disc procedure/injection using CPT Code 62290 (Lumbar/Sacral) and 62291 (Cervical/Thoracic). You bill per level L1-L2, L2-L3, L4-L5.

Many providers bill for 62290 (let's say for herniated disc )- 1st level for one unit and the additional level with the same code 62290 and they would append the 51 Modifier for Multiple Procedure. Meaning, they usually bill two lines on the claim, 62290 (1 unit), second line, 62290-51 for multiple procedure. Many would also append modifier -59 for Distinct Procedure modifier.

Well, with my experience, it's a big difference when I simply bill 62290 x 3 units (for 3 levels) without of course the modifier 51 or 59.

See the difference, if the payor denies additional levels, contact the insurance company. Take a look at their policy and guidelines on billing discography. But I know many insurance companies pays well with this kind of billing and coding discography.

By the way, use CPT Code 72275 for the radiology code. One unit for one region. Two units for two different regions (for example on Lumbar and Cervical). Append Modifier -26 if done in the ASC (Ambulatory Surgical Center) or at the Outpatient Hospital.

1 comment:

  1. Anonymous3:48 PM

    HI pinky...thanks for this blog. Im learning a lot of things. I just started working in medical billing a month ago and boy am i soo confused. We've been getting denials for radiology codes 76680 and 77003, stating that our provider is not priviledged to render the service. Do we need our Doctors to be Radiology certified in order to get reimbursements for these CPT codes?

    ReplyDelete

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