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Ann Matlack, CPC Olympia WA

  1. #1
    Cool Ann Matlack, CPC Olympia WA
    Medical Coding Books
    Cervical bundling issue.
    Effective Jan 2011 CMS created a new code 22551 this replaces the code set 22554 Cervical arthrodesis with 63075 Cervical discectomy. Starting this year I am receiving requests from our AR group indicating that when a cervical corpectomy 63081 (which includes discectomy is billed with the combined code 22551 (arthrodesis with discectomy) that the payors are now bundling the corpectomy with the combined new code because both codes contain the discectomy. My inclination is to code the corpectomy 63081 and the original code for the arthrodesis 22554. Has anyone else run across this issue and does my solution sound viable? Have not found president re billing the codes as I think I can. Any advise would be greatly appreciated.
    Will see you all in Vegas in April!!!!

    Thanks!

    Ann Matlack, CPC
    Olympia Orthopaedics Assc
    360-491-8439 ex 1108
    amatlack@olyortho.com
    Last edited by amatlack; 02-10-2012 at 02:11 PM.

  2. Default
    Quote Originally Posted by amatlack View Post
    Cervical bundling issue.
    Effective Jan 2011 CMS created a new code 22551 this replaces the code set 22554 Cervical arthrodesis with 63075 Cervical discectomy. Starting this year I am receiving requests from our AR group indicating that when a cervical corpectomy 63081 (which includes discectomy is billed with the combined code 22551 (arthrodesis with discectomy) that the payors are now bundling the corpectomy with the combined new code because both codes contain the discectomy. My inclination is to code the corpectomy 63081 and the original code for the arthrodesis 22554. Has anyone else run across this issue and does my solution sound viable? Have not found president re billing the codes as I think I can. Any advise would be greatly appreciated.
    Will see you all in Vegas in April!!!!

    Thanks!

    Ann Matlack, CPC
    Olympia Orthopaedics Assc
    360-491-8439 ex 1108
    amatlack@olyortho.com
    Hey Ann~ The May 27, '11 Ortho PinkSheets has a great article about this! It says the AMA and NASS both agree it depends on how much bone is removed...saying 50% of the vertebral body needs to be removed to justify billing 63081 in addition to 22551. If you don't have access to the Ortho PinkSheets from DecisonHealth, maybe one of your Docs has access to NASS? This subject is referenced there under the Common Coding Scenarios.
    Jenna

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