Neurosurgery Coding Alert

Question: I am telling a provider that we can't bill a corpectomy (63090) to prepare the interspace for a cage in an ALIF [anterior lumbar interbody fusion]. They are asking why CPT says you can bill fusion, 22558 (Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace [other than decompression]; lumbar) with 63090. All my research leads me to the conclusion that a corpectomy is a primary procedure and shouldn't be reported for any other reason, other than to decompress. How should I respond?Pennsylvania SubscriberAnswer: You would need to determine if the surgeon performed decompression that involved a corpectomy. If not, the definition of the service should be enough to tell the provider the corpectomy (63090,Vertebral corpectomy [vertebral body resection], partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment) cannot be done without decompression [...]