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Thread: 22551 with Corpectomy code

  1. #1

    Default 22551 with Corpectomy code

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    Hi,
    I am getting denials from Blue Cross for the new Cervical Arthrodesis code. Blue Cross will not pay 22551 when coded/billed with 63081. The book does not state that a Cervical Corpectomy is included with CPT 22551.
    Has or this happening to anyone else? Thanks for any and all input.

  2. #2
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    Quote Originally Posted by celesteturner View Post
    Hi,
    I am getting denials from Blue Cross for the new Cervical Arthrodesis code. Blue Cross will not pay 22551 when coded/billed with 63081. The book does not state that a Cervical Corpectomy is included with CPT 22551.
    Has or this happening to anyone else? Thanks for any and all input.

    When using the corpectomy codes, the disc above and below the vertebral segment site are included and discectomy for decompression codes are not separately reported. 63075/63076 (which is a component of 22551) are not separately reported unless done at another site. By billing 63081 and 22551, you are essentially trying to report the discectomy twice. This may be a matter of reporting 63081 and 22554 (assuming a fusion was done and same site)
    Last edited by RebeccaWoodward*; 05-27-2011 at 01:44 PM.

  3. #3

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    Quote Originally Posted by RebeccaWoodward* View Post
    When using the corpectomy codes, the disc above and below the vertebral segment site are included and discectomy for decompression codes are not separately reported. 63075/63076 (which is a component of 22551) are not separately reported unless done at another site. By billing 63081 and 22551, you are essentially trying to report the discectomy twice. This may be a matter of reporting 63081 and 22554 (assuming a fusion was done and same site)
    Its the same site. They are doing the fusion at C5-C6 and doing a corpectomy at both C5-C6 verterbal segments. So even though, 22551 does not specifically state that a corpectomy is included, I cannot code/bill for 63081?

    I know that I can still use 22554 and 63081 with Workers Compensation. But for regular PPo/HMO insurance, i am not sure if still use 22554 and 63081.

  4. #4
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    Quote Originally Posted by celesteturner View Post
    Its the same site. They are doing the fusion at C5-C6 and doing a corpectomy at both C5-C6 verterbal segments. So even though, 22551 does not specifically state that a corpectomy is included, I cannot code/bill for 63081?

    I know that I can still use 22554 and 63081 with Workers Compensation. But for regular PPo/HMO insurance, i am not sure if still use 22554 and 63081.
    Per AANS, 22554 and 63081 are billable. I have an article regarding this. Do you want me to fax/email a copy?

  5. #5

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    Quote Originally Posted by RebeccaWoodward* View Post
    Per AANS, 22554 and 63081 are billable. I have an article regarding this. Do you want me to fax/email a copy?
    Yes, please. My fax number is 310-322-6660. Do you have anything in regards 22551 as included/bundled with 63081.

    Thank you for answering all my questions. I appreciate it!

  6. #6
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    Quote Originally Posted by celesteturner View Post
    Yes, please. My fax number is 310-322-6660. Do you have anything in regards 22551 as included/bundled with 63081.

    Thank you for answering all my questions. I appreciate it!
    I don't have anything in writing. The rational for not reporting 22551/63081 together is that discectomies above and below are included in the corpectomy code. 22551 (22554 + 63075) represents the fusion and the discectomy. Since the discectomy is included, that leaves you with 22554; which is reportable with 63081.

  7. #7

    Talking

    The reason they are probaly denying is because medicare bundles corpectomies and osteotomies to 22551...

  8. #8

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    Quote Originally Posted by RebeccaWoodward* View Post
    I don't have anything in writing. The rational for not reporting 22551/63081 together is that discectomies above and below are included in the corpectomy code. 22551 (22554 + 63075) represents the fusion and the discectomy. Since the discectomy is included, that leaves you with 22554; which is reportable with 63081.
    Rebecca,
    Would you mind emailing (cvasquez@rbjc.com) or faxing (713-452-4167) a copy to me? A co-worker and I have been trying to make sense of this. Your help is greatly appreciated.
    Thanks!

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