Neurosurgery Coding Alert

Question: Our neurosurgeon did T6 and T7 vertebral corpectomies with T6-7, T5-T6 and T7-T8 diskectomies and decompression of spinal canal. An allograft humeral cylindrical strut was placed from T5-T8. Lateral titanium plate/screw fixation was done from T5-T8 for fusion/arthrodesis. How can we report this procedure?

Answer: Assuming that an anterior approach (thoracotomy) was used, the corpectomy of T6 and T7 includes the adjacent discectomies and would be reported with 63085 (Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment) and +63086 (Vertebral corpectomy [vertebral body resection], partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root[s]; thoracic, each additional segment [List separately in addition to code for primary procedure]) for the two levels of decompression. 

The anterior arthrodesis involved T56, T67, and T78 and would be reported with 22556 (Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace [other than for decompression]; thoracic) -51(Multiple procedures) and 22585 (Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace [other than for decompression]; each additional interspace [List separately in addition to code for primary procedure]) x2.  The humeral allograft would be reported with +20931 (Allograft, structural, for spine surgery only [List separately in addition to code for primary procedure]) and the anterior plate screw instrumentation over 4 levels would be reported with 22846 (Anterior instrumentation; 4 to 7 vertebral segments [List separately in addition to code for primary procedure]).