Neurosurgery Coding Alert

Question: Our neurosurgeon worked with an orthopedic surgeon during a patient's spinal fusion. The neurosurgeon performed the decompression and they worked as co-surgeons for the fusion. The orthopedist completed the instrumentation, but our neurosurgeon assisted. How do we bill for the neurosurgeon's part in the surgery? North Dakota Subscriber Answer: Start by reporting the decompression with 63001 (Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy [e.g., spinal stenosis], 1 or 2 vertebral segments; cervical) and the fusion with 22590 (Arthrodesis, posterior technique, craniocervical [occiput-C2]). The correct code for the instrumentation is +22840 (Posterior non-segmental instrumentation [e.g., Harrington rod technique, pedicle fixation across one interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation] [Listseparately in addition to code for primary procedure]), which CMS states has a payment status indicator of 1 for co-surgery. This means that co-surgeons could be paid [...]