Wiki Any luck billing 22612/bilat?(spine fusion)

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profmedgirl

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Hi, all:

Having trouble with spine fusions, my doc feels he should be reimbursed for CPT code 22612, 22614 and 22840 performed bilat on left and right sides of the spine without a separate incision, any one have this issue and know how to get it paid? I know you can not bill it with mod 50, lt/rt or 51, do you think I should try mod 22 and document?

thnx
profmedgirl
 
Wouldn't it be unusual to fuse just one side? It's my understanding that the fusion procedures are not to be billed bilaterally. I believe that's why Medicare doesn't allow the bilateral modifier or RT-LT. Also, our spine surgeon never tries to bill bilaterally and he certainly would if he thought he could. Hope this helps. Sorry I don't have anything really official.
 
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