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Spine Surgery Question

  1. #1
    Seattle First Hill
    Default Spine Surgery Question
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    Doctor removed and then reinserted PEEK cage at the same level. Is there a code for the removal? Or do I just go with the 22851?

    Thanks in advance,

    Kirsten, CPC

  2. #2
    North Carolina
    Typically, the removal of the cage if inherent to the definitive procedure. Removal of instrumentation (i.e. 22855) isn't separatley reportable with reinsertion at the same level (i.e.22849). Without the specifics of the case, it's hard to say but I would tend to lean towards 22851 with the primary/definitive procedure.

  3. #3
    Seattle First Hill
    The doctor did a revision lumbar anterior fusion for pseudoarthrosis. I was just going to code the 22851 and 22558, however, I was told to also code the removal of the cage with a 22855-51.
    That seems somewhat redundant to me. Should I have coded the 22849 and 22558 only? Does a cage count as a "spinal fixation device"?

    Thanks for your help!

    Kirsten, CPC

  4. #4
    North Carolina
    Removal (22855) is not billable since there was placement of new instrumentation at the same level.

    I agree with you...I would go with 22558 and 22851. In my opinion, 22849 is inherent to 22558 since the fusion is the definitive procedure. You do present a good question, though. Typically, 22849 describes wires, screws, cables, plates and rods. I'm not sure if cages fall into this description. I'm going to research this.

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