• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Two Phase Spinal Surgery

Create Wiki
T

tboback

Networker
Messages
43
Location
Belleville, MI
Best answers
0
Phase 1 was coded:
22558 - Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace; lumbar
22845 - Anterior instrumentation; 2 to 3 vertebral segments
22851 - Application of intervertebral biomechanical cage
20930 - Allograft, morselized, or placement of osteopromotive material, for spine surgery only

Phase 2 op note says:
PREOPERATIVE DIAGNOSIS: L5-S1 instability.
POSTOPERATIVE DIAGNOSIS: L5-S1 instability.
OPERATION PERFORMED: L5-S1 pedicle screw instrumentation.
INDICATIONS: The patient underwent anterior lumbar interbody fusion 2 days ago. She now presents for the second phase of the surgery, posterior instrumentation.

PROCEDURE IN DETAIL: Procedure was performed under general anesthesia in
prone position over bolsters on a Jackson table. Following a preparation
to the skin, using AP and lateral fluoroscopy, we accessed the L5 and S1
pedicles. This was followed by a tap and then screws. A connecting rod
was then placed between the screws on either side. Locking top loading
mechanisms were engaged and tightened. The screw extenders were then
broke off. Following irrigation and hemostasis, fascia was reapproximated
and skin was closed with subcuticular closure. EMG monitoring remained
stable throughout the tapping and screw insertion. Minimal blood loss was
encountered and no difficulties noted.

Per doctor no arthrodesis was done.

All I get for a code is +22842-58 - Posterior segmental instrumentation (can't bill without primary code)

Anyone get something different for Phase 2??
 
tboback said:
Phase 1 was coded:
22558 - Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace; lumbar
22845 - Anterior instrumentation; 2 to 3 vertebral segments
22851 - Application of intervertebral biomechanical cage
20930 - Allograft, morselized, or placement of osteopromotive material, for spine surgery only

Phase 2 op note says:
PREOPERATIVE DIAGNOSIS: L5-S1 instability.
POSTOPERATIVE DIAGNOSIS: L5-S1 instability.
OPERATION PERFORMED: L5-S1 pedicle screw instrumentation.
INDICATIONS: The patient underwent anterior lumbar interbody fusion 2 days ago. She now presents for the second phase of the surgery, posterior instrumentation.

PROCEDURE IN DETAIL: Procedure was performed under general anesthesia in
prone position over bolsters on a Jackson table. Following a preparation
to the skin, using AP and lateral fluoroscopy, we accessed the L5 and S1
pedicles. This was followed by a tap and then screws. A connecting rod
was then placed between the screws on either side. Locking top loading
mechanisms were engaged and tightened. The screw extenders were then
broke off. Following irrigation and hemostasis, fascia was reapproximated
and skin was closed with subcuticular closure. EMG monitoring remained
stable throughout the tapping and screw insertion. Minimal blood loss was
encountered and no difficulties noted.

Per doctor no arthrodesis was done.

All I get for a code is +22842-58 - Posterior segmental instrumentation (can't bill without primary code)

Anyone get something different for Phase 2??
Click to expand...


I believe Phase 2 should be coded as 22899, since there is no primary code, for this day, to add the instrumentation code on to. See this earlier thread regarding similar situation:

https://www.aapc.com/memberarea/forums/showthread.php?t=92413&highlight=22899

Hope this helps!
 
You must log in or register to reply here.
Top