My doc submitted the following for arthrodesis for kyphosis;, 22160 and 22614 x5 (with instrumentation, grafts, etc). My question is - should we bill 22800 instead of 22160 and 22614? 22160 and 22614 appropriate (depending on the approach)??? I can't decipher his note.....someone....please help.

Here is the meat of the op report:

After this was completed, then entry points were selected for the lumbar pedicle
screws using the image guidance system. Starting holes were drilled using the
Midas Rex high speed pneumatic drill with matchstick bit. Then the image-guided
awl was used to start the holes for placement of the screws. These were then
checked using a pedicle screw probe and found to be patent. Then a tap provided
by the pedicle screw manufacturer was used to thread the holes. After this step
was completed, then the pedicle probe was again used to assess for breakage,
none was noted. At this point, a polyaxial screw was placed. After the initial
pedicle screw in the L4 level was placed, then the contralateral side was
targeted, probed, tapped, and the screw was placed in the same fashion. This
process was completed at the L4, L3 and L2 levels, as well as at the T12, T11
and T10 levels. Reduction screws were placed in the lumbar spine pedicles and
standard polyaxial screws were placed in the thoracic pedicles. After these
were completed, then attention was turned to the laminectomy and pedicle

The combination of rongeurs was used to remove the spinous process, lamina and
inferior and superior facets of the L1 posterior elements. After this was
completed and the top of the pedicle was well exposed, then the Midas Rex high
speed pneumatic drill with matchstick bit was used to drill the cancellous bone
within the pedicles bilaterally. This was drilled down into the vertebral body,
hollowing out the vertebral body and then after this was completed, then
curettes were used to complete a tunnel through the vertebral body between the 2
hollowed out pedicles and to further remove cancellous bone. At this point, the
cortical bone was removed from the posterior wall, with care taken to avoid
damage to the thecal sac during this process. As the spine became more
unstable, then a temporary rod was placed, first on the left and later on the
right side, to assist with stabilization of the spine, while still allowing
continued dissection. After the posterior wall was removed, then wedge
osteotomies were completed in the cortical bone of the bilateral vertebral

Prior to complete removal of the cortical bone, the periosteal resection was
performed and protective retractors were put in place to prevent damage to the
retroperitoneal structures. After the wedge osteotomy was completed, then both
rods were bent to the appropriate shape and put in place. Reduction was
performed across the L1 body, causing decrease in the height of the posterior
body and realignment of the endplates. Once this compression was completed and
the bony edges of the osteotomy were noted to be immediately opposed against
each other,...

Thanks for any help you can give....