Wiki L4-5 instrumentation help please

[icys@aol.com]

Pre op dx: Laminectomy syndrome post l4-5 fusion and instrumentaion. New l3/l4 mechanical instability
procedure performed:
1.removal of l4-l5 instrumentation
2.new l3/l4 fusion and instrumentation
3.l3/l5 posterir instrumentation pedicle screw system
4.ssep recording 4hours
5.fluoroscopy 1hour

i have codded: 22612(l3-l4), 22842 (l4-l5),95926 mod 26, 76000

what do you advice please. Thank you.
Regards

 

[sebastianaj]

You should only code 22612 if the fusion was posterlateral and not just interbody.
You should also code for the removal of instrumentation at the L4/5 level, since it was not reinserted. (22850)
If instrumentation was only inserted in one level, you should use 22840.