Wiki Arthrodesis of C7-T1

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tobieforte

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Hi, I'm new to spine sx, and I just want to make sure I'm coding this correctly. I'm coding the arthrodesis of C7-C8 as 22551, but it's the C8-T1 that's causing the problem. I'm not sure whether I should code it as 22552 or as 22585, but the notes state to "use 22585 in conjunction with 22554, 556, or 558" not 22551. Please help!
 
tobieforte said:
Hi, I'm new to spine sx, and I just want to make sure I'm coding this correctly. I'm coding the arthrodesis of C7-C8 as 22551, but it's the C8-T1 that's causing the problem. I'm not sure whether I should code it as 22552 or as 22585, but the notes state to "use 22585 in conjunction with 22554, 556, or 558" not 22551. Please help!
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If the same work (discectomy, decompression, arthrodesis) that was done at the first level was also done at the second level, you will use 22551 & 22552. If this is isn't the case, please give more info/post scrubbed op note here for additional guidance.
 
Anatomically, for the Skeletal aspect, there are only 7 Cervical Vertebrae. From the Neurological, Spinal Cord aspect, there are 8 Cervical Cord Segments with 8 Cervical Nerves. There is no way to Arthrodese C8 and T1 since there is no C8 vertebra. The lowest Cervical Fusion that can be done is C7-T1. The 8th Cervical Nerve exits the spine between C7 and T1. The difference between the Skeletal and Neurological Anatomy make things confusing.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com
 
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