Anesthesia Coding Alert

Question: I have documentation from my anesthesiologist who performed a service for surgical codes 22554 and +22840. Which code should I use to crosswalk?

Texas Subscriber

Answer: Code +22840 (Posterior non-segmental instrumentation [e.g., Harrington rod technique, pedicle fixation across one interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation] [List separately in addition to code for primary procedure]) is an add-on code, so surgical coders may not report the code by itself on a claim.

You must report it with the primary procedure -- in this case, 22554 (Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace [other than for decompression]; cervical below C2).

Caution: Usually, you use the anesthesia code that crosses to a primary procedure rather than a code that crosses to an add-on procedure, but don't assume this is always the right thing to do.

Instead of instructing you to go directly to the primary code, Crosswalk instructions allow you to code from the add-on codes, +22840.

Coding for 22554 and +22840, you'll find that the primary code crosses only to 00600 (Anesthesia for procedures on cervical spine and cord; not otherwise specified) in the Crosswalk.

Code 00600, which is attached to the primary code, has a base 10 value. However, the add-on code crosses to 00670 (Anesthesia for extensive spine and spinal cord procedures [e.g., spinal instrumentation or vascular procedures]), which carries 13 base units. If you don't search for the instrumentation code in the Crosswalk, you would underreport your anesthesia provider's services by three units.