Wiki ACDF with Foraminotomy (22551 with 63045?)

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lpalladino

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Can someone clarify if I can use CPT 22551 with 63045?

Complete radical discectomy was then performed in the C5-C6 level utilizing series of pituitaries and curettes as well as Kerrison rongeurs. Once complete discectomy was performed, cartilaginous endplates were decorticated with curettes. Posterior longitudinal ligament as well as posterior osteophytes were resected with triple zero curved curette as well as 1- and 2-mm Kerrison rongeurs. Formainotomies were performed bilaterally. The wounds were thoroughly irrigated with antibiotic irrigating solution....

(FYI - the foraminotomy was performed due to stenosis
 
Just the foraminotomy portion. I assume that this is included in the "disc space preparation" portion of the 22551, just want to make sure I am not missing any possibly billable charges.
 
22551 includes the discectomy and decompression of spinal cord and/or nerve roots at the same interspace so you will not report the foraminotomy separately at the same interspace. You will report 22551 plus any interbody cage 22853 or structural graft 20931 in this scenario for an anterior approach. IF this was a posterior approach then you can code the Posterior fusion 22600 and foraminotomy 63045 separately at the same interspace.
 
agibbons said:
22551 includes the discectomy and decompression of spinal cord and/or nerve roots at the same interspace so you will not report the foraminotomy separately at the same interspace. You will report 22551 plus any interbody cage 22853 or structural graft 20931 in this scenario for an anterior approach. IF this was a posterior approach then you can code the Posterior fusion 22600 and foraminotomy 63045 separately at the same interspace.
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I've dabbled in spine but we have never had a spine surgeon in our clinic. Code 22551 includes the foraminotomy in the code description, so how come it does not hit an edit? Do you know?
 
Orthocoderpgu said:
I've dabbled in spine but we have never had a spine surgeon in our clinic. Code 22551 includes the foraminotomy in the code description, so how come it does not hit an edit? Do you know?
Click to expand...
Because 22551 is Anterior and 63045 is posterior. You could only consider the two together if the patient was physically flipped on the table between each approach.
 
agibbons said:
22551 includes the discectomy and decompression of spinal cord and/or nerve roots at the same interspace so you will not report the foraminotomy separately at the same interspace. You will report 22551 plus any interbody cage 22853 or structural graft 20931 in this scenario for an anterior approach. IF this was a posterior approach then you can code the Posterior fusion 22600 and foraminotomy 63045 separately at the same interspace.
Click to expand...
Wouldn't that be 22633 instead?
 
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