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RESPONSES / COMMENTS (CODINGLINE)

04/02/2009     




RE: Coding for the Topaz Procedure (Harry Goldsmith, DPM)
From: Bruce Werber, DPM

I respectfully disagree with Dr. Goldsmith's response in regard to coding for radio frequency coblation (Topaz being one type of handpiece that provides a low temp bipolar plasma field). Radio frequency coblation is an instrument, just like a scalpel, or arthroscope, or a retractor. This modality is used in a variety of procedures from arthroscopic synovectomy, to tendon repair, to treating plantar fasciosis.

Would you submit an unlisted CPT code if one used a new type of scapel or saw blade to perform a chevron osteotomy? Of course not, so why would we use an unlisted CPT code for using radio frequency coblation for tendon repair, or in treating plantar fasciosis. If you are treating tendinosis using radio frequency coblation, use the appropriate code for tendon repair. If you are performing an arthroscopic synovectomy, then use the appropriate code for that procedure. 

The literature is clear that radio frequency coblation has a measurable effect on the tissue to initiate angiogenesis and release of growth factors within tendon and fascia that have been injured to resolve the tendinopathy and/or fasciosis and return the patient to more normal functioning.

Bruce Werber, DPM, Scottsdale, AZ, docwerber@gmail.com