Tlif w removal of xstop

[sdunaway1]

1) REMOVAL OF PRIOR L4-5 X-STOP DEVICE
2)TRANSVERSE LUMBAR DECOMPRESSION AND MICRODISCECTOMY
3)TRANSVERSE LUMBAR INTERBODAY FUSION USING CALIBER EXPANDABLE CAGE FROM GLOVUS W VITOSS AND MORROW ASPIRATE AND MORCELLIZED ALLOGRAGT BONE
4)L4-5 POSTERIOR LUMBAR FUSION W PEDICLE SCREW ROD FIXATION
5)LEFT ILLIAC BONE MARROW ASPIRATION FOR AUGMENTATION OF THE FUSION
6)FLUOROSCOPY FOR 31/2 HOURS

I HAVE CODED THIS OUT AS :

22633-TLIF W CAGE
63042-REDO DECOMPRESSION
22840-INSTRUMENTATION
22899-REMOVAL OF XSTOP OR 22830 EXPLORATION OF SPINAL FUSION
22851-CAGE
38220- BONE MARROW BX
76001-FLOUROSCOPY
20930-GRAFT

Can someone pls take a second look at these codes and let me know what you think? I am unsure if I should code the removal or the exploration because it is one level.
thank you for your time.

 

[LLynn29]

You should report the exploration-22830 as long as it's described in depth in the notes. I'm not sure about the removal of the X-STOP , is it considered to be the same as instrumentation? Our surgeons don't use this device.

 

[LLynn29]

You should report the exploration-22830 as long as it's described in depth in the notes. I'm not sure about the removal of the X-STOP, is it considered to be the same as instrumentation? Our surgeons don't use this device.

 

[sdunaway1]

The insertion code for the X stop is 0171T. There is no official code right now for the removal. Per Medtronic Spineline we should use the 22899, which is an unlisted code w notes. When I look at descriptions of this code it does state interspinous process implant- I do not believe they are looking at this device as instrumentation.

 

[teridmac]

X Stop removal

I would use 22899...

Also, I was always taught that fluoro is bundled. Do you have documentation that fluoro can be seperately billed? I don't code for the fluoro.

Thanks

 

[SJMarra]

Per AANS, the removal of the XSTOP is coded as 22899.