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separate fusion T3-7 & L2-5

JLM929

Networker
Messages
36
Best answers
0
Need Help!
I have a patient who had 2 separate fusions in the same setting. Fusion T3-T7 and L2-L5. Would you code 22612, 22614 x6 or 22610, 22612, 22614 x5? I am not sure if you can code 22610 & 22612 together on the same claim.:confused: i am not finding any information on how to proceed.
Any feedback welcome.
thanks
 

CANTYC

New
Messages
2
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0
I'm assuming 2 separate incisions were done & documented, so I would use the 22612, 22610/59, 22614x5 units. Per CCI the 22610 & 22612 are bundled so you would use the modifier to show the separate site/incision.
 

JYSPA

Networker
Messages
44
Location
palo alto
Best answers
0
If not mistaken, I read in a Medicare 2014 (recent) article that it can be coded two primary (22610 with 22612) if not are not contiguous and in different regions of the spine, the physician may report one primary code for each non-contiguous region. It's good to make sure so that you don't want to loose reimbursement.

It is a pdf. file at :

http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html?redirect=/nationalcorrectcodinited/

NCCI Policy Manual for Medicare Services - Effective January 1, 2014 [ZIP, 749KB]

Look at #15 for CPT 20000-29999
 
Last edited:

taparker

Contributor
Messages
19
Best answers
0
I had to reread the that; it gave me a scare! I thought I might have been coding these wrong, but this doesn't apply to what we usually do. The majority of the fusions we do like this are contiguous. I will make a note of this for the future though!
 

mhstrauss

True Blue
Messages
1,241
Location
Baton Rouge
Best answers
0
If not mistaken, I read in a Medicare 2014 (recent) article that it can be coded two primary (22610 with 22612) if not are not contiguous and in different regions of the spine, the physician may report one primary code for each non-contiguous region. It's good to make sure so that you don't want to loose reimbursement.

It is a pdf. file at :

http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html?redirect=/nationalcorrectcodinited/

NCCI Policy Manual for Medicare Services - Effective January 1, 2014 [ZIP, 749KB]

Look at #15 for CPT 20000-29999

Thanks for the correction!!! :)
 
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