# Spine Exposure for ALIF procedure



## smorton255 (Jul 29, 2008)

My general surgeon does spine exposure for ALIF procedures that are performed by a neuo surgeon. We are billing 22558 with a 62 modifier. My Physician thinks I am not billing enough. If anyone has any experience with this, I welcome suggestions. 
Thanks  
Susan Morton, CPC, CPC-GENSG


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## RebeccaWoodward* (Jul 30, 2008)

My neurosurgeon asked this very question yesterday.  Here's the information I was able to provide.  This can be located in the Neurosurgery Coding Alert.

Q: How should I code when a general surgeon performs the surgical exposure for a spinal fusion?  A neurosurgeon performs the arthrodesis itself.

A: Access and closure are an inherent part of any surgical procedure, including arthrodesis.  You cannot "separate out" the exposure for coding purposes or for separate payment.
    Because the general surgeon and neurosurgeon are working together to provide a single identifiable procedure (22558), you may gain reimbursement for both surgeons by proper application of modifier 62. To qualify as co-surgeons, the operating surgeons must share responsibility for the surgical procedure, with each serving as a primary surgeon during some portion of the procedure, according to chapter 20, section 40.8.B of the Internet Only Manual (IOM).  The general surgeon would report 22558-62 for the approach and the neurosurgeon would also report 22558-62 for the fusion.

I also found a link at the NASS website that addresses this question~

http://www.spine.org/Pages/PracticePolicy/CodingAndReimbursement/FrequentlyAskedQuestions.aspx


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## mmelcam (Jul 30, 2008)

We also do the exposure for the spine surgeries and that is also how we bill it.


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