Editorial

ISSP Coding System Uniform Nomenclature for Interventional

Pain Procedures
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Introduction Category
The vision statement of Indian society for the study of pain 1. Joints, bursa, tendons, ligaments, and muscles
is “Working together for pain relief.” Keeping that in mind, 2. Nerves
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ISSP has formed various special interest groups (SIGs) to 3. Epidurals

formulate the guideline and protocols to bring the uniformity 4. Vertebral augmentation
in the pain practice throughout India. SIG coordinators 5. Neurostimulation
have been appointed, and the members of ISSP are joining 6. Intrathecal drug delivery
the groups voluntarily. One such group is looking after the 7. Intradiscal procedures
documents. 8. Endoscopic/epiduroscopic procedures
9. Pain biologics
Minimally invasive pain and spine interventions coding system 10. Others.
is developed, primarily as a unique system to bring uniformity
in the terminologies used for interventional pain procedures
2. Nerves
and provide a uniform language applicable to medical
education, research, and processing of insurance claims.[1] Procedures Codes
Codes are given to interventional pain procedures which are Greater occipital nerve: Diagnostic block MIPSI‑B‑001
approved as per international guidelines[2] and evidence except Greater occipital nerve: RF ablation MIPSI‑B‑002
those with negative recommendations. Lesser occipital nerve: Diagnostic block MIPSI‑B‑003
Lesser occipital nerve: RF ablation MIPSI‑B‑004
We do hope that more and more pain physicians will adopt Third occipital nerve: Diagnostic block MIPSI‑B‑005
these protocols, and ISSP will be able to achieve its goal to Third occipital nerve: RF ablation MIPSI‑B‑006
bring the uniformity throughout India soon. Suprascapular nerve block for shoulder manipulation MIPSI‑B‑007
PRF of suprascapular nerve MIPSI‑B‑008
Intercostal nerve (single) MIPSI‑B‑009
1. Joints, bursa, tendons, ligaments, and muscles Intercostal nerves (multiple) MIPSI‑B‑010
Ilioingunial/Iliohypogastric nerves: Diagnostic block MIPSI‑B‑011
Procedures Codes
Trigeminal nerve (any branch) ‑ Diagnostic block MIPSI‑B‑012
Major joint/bursa intervention (knee, hip, shoulder, MIPSI‑A‑001 Trigeminal nerve (any branch) ‑ Radiofrequency MIPSI‑B‑013
trochanteric bursa, subacromial bursa, pes anserine ablation
bursa)
Sphenopalatine ganglion: Diagnostic block MIPSI‑B‑014
Intermediate joint/bursa MIPSI‑A‑002
intervention (temporomandibular, acromioclavicular, Sphenopalatine ganglion: Radiofrequency ablation MIPSI‑B‑015
wrist, elbow, ankle, olecranon bursa) Stellate ganglion (cervical sympathetic): Diagnostic MIPSI‑B‑016
Minor Joint/Bursa Intervention MIPSI‑A‑003 block
(Fingers [PIP, DIP], toes) Superior hypogastric plexus: Diagnostic block MIPSI‑B‑017
Sacroiliac joint intra‑articular MIPSI‑A‑004 Superior hypogastric plexus: Neurolysis MIPSI‑B‑018
Sacroiliac joint denervation MIPSI‑A‑005 Thoracic or lumbar paravertebral sympathetic: MIPSI‑B‑019
Shoulder arthrogram MIPSI‑A‑006 Diagnostic block
Hip arthrogram MIPSI‑A‑007 Thoracic or lumbar paravertebral sympathetic: MIPSI‑B‑020
Neurolysis
Tendon sheath or ligament (iliolumbar ligament, trigger MIPSI‑A‑008
finger, De Quervain’s tenosynovitis, plantar fascia Ganglion Impar: Diagnostic block MIPSI‑B‑021
Cervical facet joint intra‑articular intervention MIPSI‑A‑009 Ganglion Impar: Radiofrequency ablation MIPSI‑B‑022
Thoracic facet joint intra‑articular intervention MIPSI‑A‑010 Celiac plexus: Diagnostic block MIPSI‑B‑023
Lumbar facet joint intra‑articular intervention MIPSI‑A‑011 Celiac plexus: Chemical neurolysis MIPSI‑B‑024
Cervical median branch rhizotomy (RFA) MIPSI‑A‑013 Thoracic paravertebral block MIPSI‑B‑025
Thoracic median branch rhizotomy (RFA) MIPSI‑A‑014 Lumbar paravertebral block MIPSI‑B‑026
Lumbar median branch rhizotomy (RFA) MIPSI‑A‑015 PRF dorsal root ganglion: Cervical MIPSI‑B‑027
PIP: Proximal Interphalangeal joint, DIP: Distal Interphalangeal joint, PRF dorsal root ganglion: Lumbar MIPSI‑B‑028
MIPSI: Minimally invasive pain and spine interventions, Other peripheral nerve MIPSI‑B‑029
RFA: Radiofrequency ablation PRF: Pulsed radiofrequency

© 2019 Indian Journal of Pain | Published by Wolters Kluwer - Medknow 51

 Surange: ISSP coding for Interventional pain procedures

3. Epidurals 7. Intra discal procedures

Procedures Codes Procedures Codes
Interlaminar‑cervical MIPSI‑C‑001 Discogram/discogaphy‑cervical MIPSI‑G‑001
Interlaminar‑thoracic MIPSI‑C‑002 Discogram/discography‑thoracic MIPSI‑G‑002
Interlaminar‑lumbar MIPSI‑C‑003 Discogram/discography‑lumbar MIPSI‑G‑003
Transforaminal‑cervical MIPSI‑C‑004 Cervical intradiscal ozonucleolysis MIPSI‑G‑004
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Transforaminal‑Thoracic MIPSI‑C‑005 Thoracic intradiscal ozonucleolysis MIPSI‑G‑005

Transforaminal‑lumbar MIPSI‑C‑006 Lumbar intradiscal ozonucleolysis MIPSI‑G‑006
Transforaminal‑sacral MIPSI‑C‑007 Percutaneous disc decompression MIPSI‑G‑007
Interlaminar‑sacral (caudal MIPSI‑C‑008 Lumbar IDET MIPSI‑G‑008
epidural)
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Lumbar biacuplasty MIPSI‑G‑009

Caudal decompressive neuroplasty MIPSI‑C‑009 Cervical nucleoplasty MIPSI‑G‑010
Adhenolysis: Chemical MIPSI‑C‑010 Cervical nucleotomy MIPSI‑G‑011
Adhenolysis: Mechanical MIPSI‑C‑011 Cervical RF discectomy MIPSI‑G‑012
Transforaminal neuroplasty MIPSI‑C‑012 Lumbar nucleotomy MIPSI‑G‑013
Lumbar nucleoplasty MIPSI‑G‑014
Cervical annuloplasty MIPSI‑G‑015
Lumbar annuloplasty MIPSI‑G‑016
4. Vertebral augmentation IDET: Intradiscal electrothermal therapy

Procedures Codes
Vertebral augmentation - thoracic MIPSI‑D‑001 8. Endoscopic/epiduroscopic procedures
(unipedicular or bipedicular approach)
Procedures Codes
Vertebral augmentation‑ cervical (unilateral or bilateral MIPSI‑D‑002
approach) Epiduroscopy MIPSI‑H‑001
Vertebral augmentation‑ lumbar MIPSI‑D‑003 Percutaneous endoscopic foraminoplasty lumbar MIPSI‑H‑002
(unipedicular or bipedicular approach) Percutaneous endoscopic foraminoplasty cervical MIPSI‑H‑003
Sacroplasty unilateral MIPSI‑D‑004 Percutaneous endoscopic forminotomy cervical anterior MIPSI‑H‑004
Sacroplasty bilateral MIPSI‑D‑005 approach
Vertebral augmentation with balloon‑thoracic MIPSI‑D‑006 Percutaneous endoscopic foraminotomy cervical MIPSI‑H‑005
anterior approach
Vertebral augmentation with balloon‑lumbar MIPSI‑D‑007
Percutaneous endoscopic foraminotomy cervical MIPSI‑H‑006
Vertebral augmentation with balloon‑sacral MIPSI‑D‑008
posterior approach
Percutaneous endoscopic lumbar disc decompression MIPSI‑H‑007
transforaminal approach
Percutaneous endoscopic lumbar disc decompression MIPSI‑H‑008
5. Neurostimulation interlaminar approach
PSLD MIPSI‑H‑009
Procedures Codes
PSCD MIPSI‑H‑010
Spinal cord stimulator‑trial MIPSI‑E‑001
Percutaneous lumbar inter body fixation without MIPSI‑H‑011
Spinal cord stimulator‑placement MIPSI‑E‑002 cage/graft
Dorsal root ganglion stimulator‑trial MIPSI‑E‑003 Percutaneous lumbar inter body fixation with cage/graft MIPSI‑H‑012
Dorsal nerve root ganglion MIPSI‑E‑004 Percutaneous lumbar inter body fixation with MIPSI‑H‑013
stimulator‑placement expandable cage
Removal/adjustment of leads/generator MIPSI‑E‑005 PTLIF MIPSI‑H‑014
Sacral nerve root stimulation MIPSI‑E‑006 PSLD: Percutaneous endoscopic stenotic lumbar decompression,
Peripheral nerve stimulator‑trial MIPSI‑E‑007 PSCD: Percutaneous endoscopic stenotic cervical decompression,
Peripheral nerve stimulator‑placement MIPSI‑E‑008 PTLIF: Percutaneous transforaminal lumbar interbody fixation

9. Pain biologics
Procedures Codes
6. Intrathecal drug delivery
PRP/BM/Adipose Tissue - Major Joint/Bursa MIPSI‑I‑001
Procedures Codes Intervention (knee, hip, shoulder, trochanteric bursa,
Intrathecal port MIPSI‑F‑001 subacromial bursa, pes anserine bursa)
Intrathecal pump implantation MIPSI‑F‑002 PRP/BM/Adipose Tissue Intermediate joint/bursa MIPSI‑I‑002
Intrathecal trial drug administration MIPSI‑F‑003 Intervention (Temporomandibular, acromioclavicular,
wrist, elbow, ankle, olecranon bursa)
Epidural catheter placement MIPSI‑F‑004
PRP/BM/Adipose Tissue Minor joint/bursa Intervention MIPSI‑I‑003
Epidural external port placement MIPSI‑F‑005 (Fingers [PIP, DIP], toes)
Intrathecal neurolysis MIPSI‑F‑006 PIP: Proximal Interphalangeal joint, DIP: Distal Interphalangeal joint

52 Indian Journal of Pain ¦ Volume 33 ¦ Issue 2 ¦ May-August 2019

 Surange: ISSP coding for Interventional pain procedures

Address for correspondence: Dr. Pankaj N. Surange,

10. Others Hon. Secretary, Indian Society for Study of Pain,
Director, IPSC, Dwarka, New Delhi, India.
Procedures Codes
Email: pankajsurange@yahoo.co.in
Prolotherpy MIPSI‑J‑001
Trigger point infiltration MIPSI‑J‑002 References
Trigger point dry needling MIPSI‑J‑003
1. Manchikanti L. CPT 2000: Interventional pain management coding in
Botulinum toxin (Botox) injection MIPSI‑J‑004 the new millennium. Pain Physician 2000;3:73‑85.
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Acupuncture with electrical stimulation MIPSI‑J‑005 2. American Medical Association. Current Procedural Terminology, CPT
Acupuncture without electrical stimulation MIPSI‑J‑006 2019. Chicago: American Medical Association; 2019.
Diathermy MIPSI‑J‑007
Transcuteneous electrical nerve stimulation MIPSI‑J‑008
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Shock wave therapy MIPSI‑J‑009

MIPSI: Minimally invasive pain and spine interventions This is an open access journal, and articles are distributed under the terms of the Creative
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tweak, and build upon the work non-commercially, as long as appropriate credit is given and
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procedure will evolve to deal with chronic pain and spine
conditions, the list will be updated.
Access this article online
Acknowledgment Quick Response Code:
ISSP acknowledges the contribution of SIG Chairman Website:
Dr. Gautam Das and the members of the committee of SIG. www.indianjpain.org

Dr. Rajeev Harshe; Vice Chairman and members of SIG

group on coding system for Interventional Pain procedure; DOI:
Dr. Anurag Agarwal, Dr. Gaurav Goyal, Dr. Pavan Kumar 10.4103/ijpn.ijpn_50_19
Bichal, Dr. Manish Raj, Dr. Nazir Ahmad, Dr. Sweta
Salgaonkar, Dr. Rohit Lahori, Dr. Ashish Chakrborty.

Pankaj N. Surange How to cite this article: Surange PN. ISSP coding system uniform
Hon. Secretary, Indian Society for Study of Pain, nomenclature for interventional pain procedures. Indian J Pain
Director, IPSC, Dwarka, New Delhi, India. 2019;33:51-3.

Indian Journal of Pain ¦ Volume 33 ¦ Issue 2 ¦ May-August 2019 53