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Thread: CPT 22551 vs 22554 & 63075

  1. #1

    Default CPT 22551 vs 22554 & 63075

    Promo: Code Books
    What's the difference?

    When would 22554 & 63075 be appropriate? When would 22551?

    Am I the only one that's confused?

    Any help will be greatly appreciated!

    Thank you.

  2. #2
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    Default

    You now report 22551 for what was traditionally reported with 63075/22554. You would report 63075 or 22554 if performed at different levels.


    http://www.karenzupko.com/resources/...hive_2011.html

  3. #3

    Default clarification on 22551, 63075 and 22554

    Rebecca,

    Can I clarify your statement and Karen Zupko's link you posted.

    "you now report 22551 for what was traditionally reported with 63075/22554. You would report 63075 or 22554 if performed at different levels."

    If I have different levels, you would STILL report 22554 and 63075-51, but if both are done at the 'same' level, you would use 22551?


    Thank you,

    Susan

  4. #4
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    Quote Originally Posted by Suzieqtk View Post
    Rebecca,

    Can I clarify your statement and Karen Zupko's link you posted.

    "you now report 22551 for what was traditionally reported with 63075/22554. You would report 63075 or 22554 if performed at different levels."

    If I have different levels, you would STILL report 22554 and 63075-51, but if both are done at the 'same' level, you would use 22551?


    Thank you,

    Susan
    22551 is a newer code, created in 2011. Prior to that, if an ACDF was performed at a single level, you would report 63075 and 22554. Since 2011, if an ACDF is performed at a single level, you report 22551 only. 63075 and 22554 both still exist for use when discectomy and arthrodesis are not performed together, but cannot be used together if both are performed at the same level; this would be bundling.

    Hope this helps clarify
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  5. #5
    Join Date
    Apr 2007
    Location
    Jacksonville, FL
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    Question Help with 22554 and 63075/63076 billed together

    Hi all!
    I've read a gabillion (ok, not that many, ha!) of these posts and am still confused. Below is the pertinent potion of the medical record I'm reviewing and I can't tell if my Dr. can or can't code the way he is.
    The codes submitted to the payer were, although I'm not going to type the entire record (The important piece to me is the 63075, 63076, 22554 combo):

    63075,
    63076-59,
    22554-59,
    22585-59,
    22845-59,
    22851-59,
    and 22851-59

    "Large anterior spurs were removed with rongeur and skinny muscles were gently dissected laterally to lateral portion of the disk. A large anterior annular window was made in the C5-C6 and subsequently C6-C7 disk space. The disk was removed as completely as possible with pituitary rongeurs, curettes, and then high speed bur was used to remove the cartilaginous cortical endplates at each level. Curette was used to explore the foramen and decompress it gently and then a 2-0 cervical Kerrisons were used to remove the posterior endplates, particularly at C5-C6 level is more spondylytic, right side more than left side and the foramen was opened bilaterally C5-C6 and left C6-C7. The disk herniation was identified and removed at left C6-C7 and posterior longitudinal ligament was take down of the left C7 to identify the dura and complete decompression of left foramen C6-C7 level............"

    I feel that's the pertinent components, and if not, please let me know. Is he correct in wanting to be paid for 22554-59/63075/63076-59?

    THANK YOU all, and have a great weekend!
    Becki, CPC, CPMA, CGIC, CHONC, CPCD

  6. #6
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    Apr 2007
    Location
    Roanoke, VA
    Posts
    278

    Default

    22554 and 63075 performed on the same level per CPT guidelines are to be billed as 22551
    (see the "do not report with" note under both codes in CPT)
    Kelly A Mcfadyen, CPC

  7. #7
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    Apr 2007
    Location
    Jacksonville, FL
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    Default

    Quote Originally Posted by KMCFADYEN View Post
    22554 and 63075 performed on the same level per CPT guidelines are to be billed as 22551
    (see the "do not report with" note under both codes in CPT)
    Ok, I thought there were some special rules like if for decompression (not just removal), they could be allowed?
    Becki, CPC, CPMA, CGIC, CHONC, CPCD

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