Orthopedic Coding Alert

Question: Our orthopedic surgeon placed two different cervical plates at different spinal levels on a patient's spine. Can I bill +22845 twice with modifier 59 attached? Texas Subscriber Answer: If the orthopedic surgeon uses two separate plates on different spinal levels, you can report +22845 (Anterior instrumentation; 2 to 3 vertebral segments [List separately in addition to code for primary procedure]) twice. You should append modifier 59 (Distinct procedural service) to the second listing of +22845. In some cases, you may have to submit your surgeon's documentation to demonstrate that he used two separate plates. Because +22845's descriptor refers to "2 to 3 vertebral segments," insurers may suspect that your practice erroneously reported two units of +22845 when the surgeon placed a plate that spanned two segments. But you should report this code twice only if the surgeon actually places two separate plates. Example: The surgeon places a plate that [...]