Wiki Billing 22633 and 63267 together for Medicare.

[mgdempsey@lexhealth.org]

Has anyone come across billing a L4-5 TLIF (22633) with a extradural cyst removal (63267) in the same L4-5 interspace (extradural but adherence to the dura)? These codes are bundled per NCCI rules and our provider is stating that they are at "different locations" and we should append modifier -59.

I've seen Karen Zupko guidance that they could be coded together but it does not specify for Medicare patients.

Thoughts?

 

[jrclark1987@yahoo.com]

Per KZA you do NOT report 63267 with 22633. This Guidance was given Jan 2022. I have not seen KZA guidance recommending reporting separately. If you have KZA guidance that differs or is more up to date, please share. Per Medicare guidelines in the musculoskeletal coding manual, it is not appropriate.

 

[mgdempsey@lexhealth.org]

What I found was much older guidance. Can you share with me where I can find the information above to share with our provider?

 

[jrclark1987@yahoo.com]

What I found was much older guidance. Can you share with me where I can find the information above to share with our provider?

It was a KZA webinar I purchased. I am not sure if you can find it on their website or not. I can try and email it to you if it is not to large. I snipped this from it.