Results 1 to 6 of 6

Thread: ACDF at C3-4 and C6-7

  1. #1

    Default ACDF at C3-4 and C6-7

    Promo: Code Books
    This procedure was performed through 2 different incisions first at C3-4 and then at C6-7. Would you code 22554 for each level or use additional level codes??

    Thanks
    Mary

  2. #2
    Join Date
    Apr 2007
    Location
    Columbus GA
    Posts
    570

    Default

    Procedure codes 22554-22558 are for SINGLE interspace, for additional interspaces, use 22585 the add-on code. Hope this helps!

  3. #3

    Default

    But what about the two separate incisions??

    Mary

  4. #4
    Join Date
    Apr 2007
    Location
    Seattle First Hill
    Posts
    126

    Default

    Since the doctor is skipping from C3-4 to C6-7, it is appropriate in this case to code both levels with a 22554. Make sure you add a -59 on the second line as well.

  5. #5
    Join Date
    Apr 2007
    Location
    North Carolina
    Posts
    3,126

    Default

    Mary,

    Since this was a separate incision and the fusion is not subsequent I would report 22554 -59 for the additional fusion site. This follows the guidelines for modifier 59 since it is a separate incision and also follows CPT Assistant from November 2007 regarding procedures that are not subsequent. Although the question pertains to instrumentation, the same concept applies.


    Question: What is the appropriate code to report if anterior instrumentation is inserted at vertebral segments C3-4 and additional instrumentation is inserted at C6-7, but vertebral segments C4-5 and C5-6 are not fused? Are the anterior instrumentation codes assigned strictly by the TOTAL number of spinal segments with instrumentation applied (ie, 22846) or is the appropriate code chosen based on the vertebral segments involved in each separate construct (ie, 22845, 22845 59)?

    Answer: Anterior instrumentation codes 22845-22847 may be reported separately with modifier 59, Distinct procedural service, appended when the procedure involves the work of putting two separate plates in the spine at different locations. Therefore, in this clinical scenario, it would be appropriate to report CPT code 22845, Anterior instrumentation; 2-3 vertebral segments, for C3-4 and CPT code 22845 with modifier 59 for C6-7.

  6. #6

    Default

    I have been having a real problem getting specific claims paid with Medicare. I have coded 22845 & 22845-59 on 2 separate OP notes. MCR has denied them due to MUE guidelines. I have sent out a 1st and 2nd level appeal was well as an appeal to an independent contractor. They all say that Medicare will only pay for 1 unit of 22845 per day. Whenever a fusion is done at C3-4, skip C4-5 and fuse at C5-6 & C6-7, is it appropriate at report 22846? I don't think it is because of the details underneath the SPINAL INSTRUMENTATION guidelines on page 118 in the CPT book. Any ideas? I hate to just write this off. Any help would be greatly appreciated.

Similar Threads

  1. ACDF in ASC
    By Bethy4444 in forum Orthopaedics
    Replies: 2
    Last Post: 04-03-2014, 01:00 PM
  2. Corpectomy with ACDF
    By staylor0907 in forum Neurology/Neurosurgery
    Replies: 1
    Last Post: 03-27-2012, 02:31 PM
  3. CPT coding Revision ACDF
    By katic23 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 04-12-2011, 12:51 AM
  4. 2 + Level ACDF
    By Jasper74 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 02-14-2011, 07:40 AM
  5. 2+ level ACDF (22851)
    By Jasper74 in forum Orthopaedics
    Replies: 1
    Last Post: 02-14-2011, 07:38 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.