Q & A with Dr. Z: Spinraza Injection


by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC

Question: SPINRAZA INJECTION
I am seeing two opinions on how to bill this. The first way is to bill with CPT code 62323 [Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)]. The second way is to bill with CPT code 96450 [Chemotherapy administration, into CNS (eg, intrathecal), requiring and including spinal puncture]. I understand 96450 includes the lumbar puncture (LP), but if billed as code 62323 can the LP be billed separately?

Answer:
We recommend 96450 for the Spinraza injection. This is the guideline from numerous payers also. The main issue with Spinraza is to review their website to be sure you are paid for the drug, which is quite expensive!

 

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About the Author

David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
David Zielske is founder and President of ZHealth Publishing and primary author and editor of ZHealth publications. Dr. Z practiced as an interventional radiologist and has over twenty years experience as a coding reviewer and coding expert. He is Board Certified in Radiology and has functioned as an independent interventional radiology, vascular surgery, and cardiovascular coding consultant to a variety of physician groups and hospital providers across the country. He also served as an instructor for over 200 coding seminars.

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