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22551 with Corpectomy code

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celesteturner

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Inglewood, CA
Hi,
I am getting denials from Blue Cross for the new Cervical Arthrodesis code. Blue Cross will not pay 22551 when coded/billed with 63081. The book does not state that a Cervical Corpectomy is included with CPT 22551.
Has or this happening to anyone else? Thanks for any and all input.
 
celesteturner said:
Hi,
I am getting denials from Blue Cross for the new Cervical Arthrodesis code. Blue Cross will not pay 22551 when coded/billed with 63081. The book does not state that a Cervical Corpectomy is included with CPT 22551.
Has or this happening to anyone else? Thanks for any and all input.
Click to expand...


When using the corpectomy codes, the disc above and below the vertebral segment site are included and discectomy for decompression codes are not separately reported. 63075/63076 (which is a component of 22551) are not separately reported unless done at another site. By billing 63081 and 22551, you are essentially trying to report the discectomy twice. This may be a matter of reporting 63081 and 22554 (assuming a fusion was done and same site)
 
Last edited:
RebeccaWoodward* said:
When using the corpectomy codes, the disc above and below the vertebral segment site are included and discectomy for decompression codes are not separately reported. 63075/63076 (which is a component of 22551) are not separately reported unless done at another site. By billing 63081 and 22551, you are essentially trying to report the discectomy twice. This may be a matter of reporting 63081 and 22554 (assuming a fusion was done and same site)
Click to expand...

Its the same site. They are doing the fusion at C5-C6 and doing a corpectomy at both C5-C6 verterbal segments. So even though, 22551 does not specifically state that a corpectomy is included, I cannot code/bill for 63081?

I know that I can still use 22554 and 63081 with Workers Compensation. But for regular PPo/HMO insurance, i am not sure if still use 22554 and 63081.
 
celesteturner said:
Its the same site. They are doing the fusion at C5-C6 and doing a corpectomy at both C5-C6 verterbal segments. So even though, 22551 does not specifically state that a corpectomy is included, I cannot code/bill for 63081?

I know that I can still use 22554 and 63081 with Workers Compensation. But for regular PPo/HMO insurance, i am not sure if still use 22554 and 63081.
Click to expand...

Per AANS, 22554 and 63081 are billable. I have an article regarding this. Do you want me to fax/email a copy?
 
celesteturner said:
Yes, please. My fax number is 310-322-6660. Do you have anything in regards 22551 as included/bundled with 63081.

Thank you for answering all my questions. I appreciate it!
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I don't have anything in writing. The rational for not reporting 22551/63081 together is that discectomies above and below are included in the corpectomy code. 22551 (22554 + 63075) represents the fusion and the discectomy. Since the discectomy is included, that leaves you with 22554; which is reportable with 63081.
 
RebeccaWoodward* said:
I don't have anything in writing. The rational for not reporting 22551/63081 together is that discectomies above and below are included in the corpectomy code. 22551 (22554 + 63075) represents the fusion and the discectomy. Since the discectomy is included, that leaves you with 22554; which is reportable with 63081.
Click to expand...

Rebecca,
Would you mind emailing (cvasquez@rbjc.com) or faxing (713-452-4167) a copy to me? A co-worker and I have been trying to make sense of this. Your help is greatly appreciated.
Thanks!
 
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