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Thread: Spine surgery

  1. #1
    Join Date
    Apr 2007

    Default Spine surgery

    Can anyone give me the valid cpt for the following procedures?

    1. Revision of anterior cervical diskectomy and fusion.
    2. Iliac crest bone grafting with an interbody at C4-C5 and C5-C6.
    3. Iliac crest bone grafting.

    Here is the complete documentation,

    A transverse incision was made through the previous scar and dissected bluntly down, laterally to the trachea and esophagus medially to the neurovascular bundle. In the deeper layers, the prevertebral fascia/fat scar tissue over the plate was identified and dissected open and the plate was identified. The soft tissue was dissected free of the plate and once the plate was fully exposed, the screws were removed. The screws at C5 and C6 were loose and were easily removed, were as at the C3 and C4 they were well-fixed.The cages seemed well-fixed and difficult to move. Adjacent to the C4-C5 and C5-C6, the interbody space was curetted off any scar tissue and the endplate was curetted/burred to allow bleeding bone. The right iliac crest had been prepped and draped out, and a longitudinal incision was made over the crest and dissected with the Bovie down to the iliac crest and a small cortical window was made with rongeur and the iliac crest bone was harvested with curved curettes. A piece of the iliac crest bone was then impacted at C5-C6 and then also at C4-C5. A slightly thinner, and slightly more curyed plate was chosen and after choosing an appropriate length, either 16 or 18 mm long, 4.5 mm diameter (previous screws were 4.0) were chosen and fixed and used to fix the plate down to the cervical vertebral body from C3 down to C6 and placement of the screws, length, as well as position were checked in AP and lateral and oblique planes. It was noted to be satisfactory. The plate was fixed very well and rigid and was checked again to make sure there was no loosening. With these findings, the wound was thoroughly irrigated and the skin and platysma was . reapproximated using absorbable sutures over a drain. Skin was infiltrated with Marcaine. Dressings were applied. A Philadelphia collar was applied. Over the right iliac crest, the wound was irrigated and closed in various layers and dressings were applied and wound was also infiltrated with Marcaine.

  2. #2
    Join Date
    Apr 2007
    South Denver


    22551 C4-5 acd&f
    22552 C5-6

    20938 for iliac crest bone grafting

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