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Neurosurgery Coding Alert

Reader Question:

Do Not Report 63056 and 22630 for Same Segment

Published on Mon Oct 22, 2012

Question: Is it ok for us to report code 63056 (Transpedicular approach with decompression of spinal cord, equina and/or nerve root[s] [e.g., herniated intervertebral disk], single segment; lumbar [including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc]) and code 22630 (Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace [other than for decompression], single interspace; lumbar) for the same interspace/segment? Alaska SubscriberAnswer: You are wrong to report codes 63056 and 22630 for the same interspace/segment as this would represent duplicative work under most circumstances. You report code 22630 for the posterior (PLIF) or transforaminal (TLIF) approach lumbar interbody fusions. The code 22630 is inclusive of the surgical work done to access the disc space including a transfacet approach and this is an incidental component of the fusion procedure. Note that the descriptor of 22630 specifies that the code includes discectomy to prepare interspace (other than [...]
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