Wiki CPT codes 22612 and 22558, same level?

[0913@70]

I need help on this, please

The surgeon has two separate reports, one for lateral fusion L3-L4, L4-L5, L5-S1 levels and one for anterior body fusion for L3-L4, L4-L5, L5-S1 levels.
I don't think that these two procedures can be billed at the same time, same level. Am I correct? Can you bill 22612 and 22558 for the same level?
The surgeon billed;
20937
22585
22585
22558-51
22614
22614
22612

Thank you

 

[skorkfranks]

I got this from the Zupko website. Hope this is helpful.

Question:


My spine surgeon did an anterior procedure followed by a posterior procedure on the same day (same patient, same anesthesia). I was told to send in two separate claims – one for the anterior procedure and the other for the posterior procedure – to get better reimbursement. I was also told to use modifier 58. Something doesn't seem right about this. What do you think?



Answer:

You are wise to question this advice. First, modifier 58 (staged or related procedure or service by the same physician during the postoperative period) is used on the second procedure when it is performed in the global period of the first procedure. A 360 degree (or front-back) procedure is performed entirely on the same surgical day, therefore, it is inappropriate to use modifier 58 in this situation.

Sending the procedures on two separate claims to avoid the multiple procedure payment reduction is not appropriate. We expect a payment reduction for secondary stand-alone procedures when performed on the same day due to overlapping pre- and post-operative global periods and activity.

 

[nyyankees]

I need help on this, please

The surgeon has two separate reports, one for lateral fusion L3-L4, L4-L5, L5-S1 levels and one for anterior body fusion for L3-L4, L4-L5, L5-S1 levels.
I don't think that these two procedures can be billed at the same time, same level. Am I correct? Can you bill 22612 and 22558 for the same level?
The surgeon billed;
20937
22585
22585
22558-51
22614
22614
22612

Thank you

you can bill these anterior & posterior fusions together..

 

[0913@70]

So , we billed correctly with the 51 modifier?


Thank you for your help