Neurosurgery Coding Alert

Question: Our surgeon does a T10-L2 posterior lumbar fusion in addition to open vertebroplasty at T10 and L2. Please advise how to report this. We are reporting diagnosis codes 737.10 (Kyphosis [acquired] [postural]) for acquired Kyphosis and 733.13 (Pathological fracture of vertebrae) for pathologic fracture.Ohio SubscriberAnswer: Assuming that a posterolateral rather than posterior interbody fusion is performed, the choice of the primary stand-alone code is up to the provider. Since the lumbar posterolateral fusion code is valued higher than the comparable thoracic code, one would report 22612 (Arthrodesis, posterior or posterolateral technique, single level; lumbar [with lateral transverse technique, when performed]) for the L1-L2 posterior arthrodesis and 3 units of 22614 (Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment [List separately in addition to code for primary procedure]) for the T12-L1, T11-T12, and T10-T11 posterior arthrodesis. Since thoracic vertebroplasty is valued higher than lumbar vertebroplasty, you would [...]