AHA Coding Clinic® for HCPCS - 2026 Quarter 3; Ask the Editor

Endoscopic Transection of Spinal Nerves

A patient with lumbar spondylosis without myelopathy presents for endoscopic transection and avulsion of the nerves at the L2, L3, L4, and L5 levels. The vertebral levels were identified under fluoroscopic guidance, a small skin incision was made, and the cannula was introduced over the guide needle in the L2 region. An endoscope was inserted through the cannula, under direct guidance. The L2 medial branch spinal nerve was transected using a rongeur and a segment was avulsed, destroying the nerve function. The same process was repeated for the left L3 and L4 medial branch spinal nerves, and for the L5 dorsal primary ramus nerve. Successful surgical destruction of each nerve via transection and avulsion was completed. The endoscope and working cannulas were removed. How is an endoscopic transection and avulsion of the lumbar region coded? ...

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