Neurosurgery Coding Alert

Question: During an operative session, my neurosurgeon performed the following procedures: L4-L5 diskectomy, L5-S1 diskectomy, L4-L5 transforaminal interbody fusion using posterior interbody technique, L5-S1 transforaminal interbody fusion using posterior interbody technique, bone graft placement (autograft), L4-L5 interbody cage placement, L5-S1 cage placement, and L4, L5, S1 bilateral pedicle screw instrumentation. How should I report this procedure?Alaska SubscriberAnswer: From the description you provide, your surgeon likely performed a transforaminal lumbar interbody fusion (TLIF) procedure. If the surgeon performed the L4- L5 transforaminal interbody fusion using a posterior interbody technique, you should report 22630 (Arthrodesis,posterior interbody technique, including laminectomy and/or diskectomy to prepare interspace [other than for decompression], single interspace; lumbar).For the L5-S1 interbody fusion, you should report +22632 (... each additional interspace [List separately in addition to code for primary procedure]). Then, report the appropriate autograft code (20936-20938) for the autograft.Next, bill one unit of +22851 (Application of intervertebral biomechanical device[s] [...]