Wiki PLIF

[pinnaclephyserv]

Am I correct on the coding? am I missing something

1. Posterior lumbar interbody fusion and posterolateral fusion L3-4. cpt 22633
2. Lumbar laminectomy with facetectomy and foraminotomy and excision of large herniated disc, L3-4 left. 63030 or 63047 cpt
3. Placement of interbody cage to lumber interspace at L3-4.
4. Placement of nonsegmental pedicle screw rod fixation L3-4. Bundled
5. Exploration of spinal fusion L4-S1. Bundled
6. Harvesting morselized iliac crest bone graft through separate skin and fascial is incision left. Bundled
7. Use of allograft bone graft. 8. Use of operative microscope the scopic light source. Bundled

 

[Yamelis]

When dealing with disk herniation 63030 is the appropriate code. However, since it was performed at L3-L4 it's considered inclusive to 22633 and it shouldn't be reported separately.
Since there was an interbody fusion you should report 22853 for the cage.
If the body of the note supports rods as the nonsegmental instrumentation it should be reported with 22840
If no procedure other than the spinal fusion exploration was performed at L4-S1, the exploration can be reported with 22830 and modifier 59
I would also report the harvesting of morselized iliac crest bone with CPT 20937 as this is not bundled.