Neurosurgery Coding Alert
Check for Removal and reinsertion of Spinal Instrumentation
Question: A patient who had a lumbar fusion from L4-S1 done in past, now needs another lumbar fusion at L3-L4. Our surgeon is going to perform Lumbar interbody fusion at L3-L4, removal of hardware from L4 through S1 and L3-S1 segmental instrumentation hardware for posterolateral fusion from L3-S1. Please help us with appropriate codes for hardware/instrumentation removal and reinsertion.
Florida Subscriber
Answer: Your surgeon would report 22630 (or 22633 if the interbody fusion is combined with a posterior fusion), a code for an interbody spacer if used (20931 or 22851) and 22842 (Posterior segmental instrumentation [e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires]; 3 to 6 vertebral segments [List separately in addition to code for primary procedure]) for segmental posterior spinal instrumentation. When the surgeon removes instrumentation and reinserts the instrumentation at the same or overlapping levels, you cannot report 22852 (Removal of posterior segmental instrumentation) and 22849 (Reinsertion of spinal fixation device) together.
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Check for Removal and reinsertion of Spinal Instrumentation
Question: A patient who had a lumbar fusion from L4-S1 done in past, now needs [...]
