Neurosurgery Coding Alert
Check Global Period for Device Repositioning
Question: Our surgeon performed surgical revision of L2 and L3 pedicle screws. In addition, he also repositioned the L2-L3 interbody spacer. The patient underwent a lumbar fusion procedure in January this year. The diagnoses documented by our surgeon include medialized pedical screw, pseudoarthrotic pedicale screw and slightly ruptured L2-L3 interbody device.
North Carolina Subscriber
Answer: Since your surgeon is doing a revision of a previous spinal instrumentation, you can report the repositioning with code 22849 (Reinsertion of spinal fixation device). If the revision procedure was done within the global period of the lumbar fusion done in January this year, you should report the code 22849 with modifier 78 (Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period).
You may also report the ICD-9 diagnosis codes 996.78 (Other complications due to other internal orthopedic device implant and graft).
Neurosurgery Coding Alert
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