Wiki 22851 & 22842


Tucson, AZ
Best answers
:confused: I work for an Orthopaedic Office and we do a lot of spinal surgerys. The doctors kept billing code 22851, 22842 on separate tickets instead of with a primary code. I got them to correct that, however i called Medicare and they stated that they only had very few Primary Proc codes allowed for those add-ons. I wrote to the FOIA for LCDs (since Medicare didnt have any) but havent received anything yet. Does anyone have any ideas or info for me to share with my docs?

CPT allowable Primary Codes: 22100...22102, 22110...22114, 22206...2207, 2210...22214, 22220...22224, 22305...22327, 22532...22533, 22548...22558, 22590...22612, 22630, 22800...22812, 63001...63030, 63040...63042, 63045...63047, 63050...63056, 63064, 63075, 63077, 63081, 63085, 63087, 63090, 63101...63102, 63170...63290, 63300...63307.

Medicare allowed codes:22325...22327, 22532...22533, 22548, 22554, 22556, 22558, 22590, 22595

Again Medicare couldnt give me any hardcopy info on these codes but i have a ton of money pending..
Thanks in advance

Sorry, i know its confusing. When I called Medicare to get the LCD for those codes to give to my team and Medicare stated that they didnt have one (on their website) but they did give me the allowed prim codes per Meidicare, however they were very limited as compared to CPT guidelines. I called twice and they told me the same thing, they also said that i had to write the FOIA to get an LCD.. I thought this was all very weird and this had never happened to me before, so i was wondering if someone had information on those codes that they could fax/email me or if they are familiar with the situation. The FOIA hasnt responded yet, just to let me know they received my request.. first come first serve. :eek:(
Does that make more sense or confuse you more..?

If the physician stated that he put a cage in at each level then you could bill 22851-59 for each. Be prepared to send a letter showing the explanation for this.