63090 Vertebral Corpectomy


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My surgeon wanted to bill 63090 (vertebral corpectomy retroperitoneal approach with decompression of spinal cord) but looking @ these procedures below, I don't think its documented and I told him that billing for this procedure a retroperitoneal approach should be documented then he said that having an anterior lumbar fusion should be part or same approach as the retroperitoneal approach. He wanted to use 63090, 22851, 22558, 22585, 20931 & 22857. Need help please..

Procedures Performed:
1) Stage 1 anterior lumbar interbody fusion L5-S1
2) Anterior lumbar interbody insertion of cage implant L5-S1
3) Anterior lumbar plate instrumentation with screws L5-S1
4) Complete diskectomy decompression L4-5, L5-S1 with decompression of the nerve roots
5) instertion of PRodisc disk arthroplasty L4-5
6) Osteotomy, endplate remodelling, L4 and L5
7) bone graft application including osteocel bone gravft
Medicare is globaling 63090 and 22558,

Why is medicare applying the global edit to 63090 and 22558? Also, which of these codes should have the modifier 62 when they neuro surgeon assist. He only assisted for the opening and closing of the surgical site.

Should i have applied the 62 modifier to 22558 instead? Dr. X provided a midline left retroperitoneal approach to l5-s1, left then came back to provide additional exposure to l4-l5 to close. Codes are 63090,62 63091,62, (medicare denying as bundled) 22558, 22585 63047, 22842, 22845, 22830,59 22612, 22614, 38220. This was a dec 2017 claim.