Wiki CPT 22849 please help!

[alexise.cervera@yahoo.com]

Hi Neurosurgery Coders

Ive been having a tough time understanding removal and reinsertion of instrumentation for arthrodesis.

If a DR. performs a L1-L5 instrumented fusion and removes the old instrumentation lets say at L1-L2 do i bill 22849 or 22842?

Another example would be removing instrumentation at C2-C5 and just adding C2-C4.

Please help!!

Alexis Cervera, CPC

 

[mms01]

Per AANS the general rule is:

If you remove and reinsert at the same level-22849

If you remove and reinsert at non-overlapping levels-code removal (22850, 22852, 22855) and new instrumentation code (22840, 22842-22844, 22845)

If old hardware is removed and new hardware is placed at overlapping levels, report only new instrumentation codes.

Hope this helps a little

 

[mschaller]

The best way I was taught is if the levels touch you can only bill 22849. So in your lumbar and cervical example you can only bill 22849.