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Is it ok to bill for the main spine procedure 22558 OLIF, 22853 for the cage, 22845 for the instrumentation, 20930 for the allograft all together? Isn't 22845 and 20930 included in the global surgery of 22558?
This is a great question. IF The device inserted has integral instrumentation needed for device anchoring then it would be inclusive. You could research information about the device or instrumentation used or query the surgeon and verify that it is not integral and if it's separate, add a 59 to the 22845 for processing and bill both codes with 22558. Grafts are usually not paid however, some carriers will pay the 20931 vs the 20930 or 20936 in many cases, these are carrier specific as well and you would need to research those and bill as per your contract. Please see 2023 NCCI policy manual for Medicare Chap 4 IV-10 for additional guidance so you can bill your optimal level of codes. Also research your products and see if they have billing sheets for guidance or code information. Zimmer Biomet has a reference guide for ACDF's online for example.