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?
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!
Complete IR and Cardiovascular Coding
Get detailed information on a broad range of Interventional Radiology and Cardiovascular procedures and the guidelines for proper coding with Complete IR and Cardiovascular Coding! Package includes 23 individual self-study medical coding elearning modules. Each module is CIRCC certified. Learn more here.