Neurosurgery Coding Alert

Question: Please help us to understand if 22595 (Arthrodesis, posterior technique, atlas-axis [C1-C2]) is bundled into 22326 (Open treatment and/or reduction of vertebral fracture[s] and/or dislocation[s], posterior approach, 1 fractured vertebra or dislocated segment; cervical)? Our surgeon did an open reduction and internal wire fixation of C1 and C2 and posterior fusion C1-C2.

North Carolina Subscriber

Answer: There isn't a CCI bundle for 22595 and 22326. You can report the two together. However, code 22326 is typically applied to traumatic fracture/dislocations in which there is a separately identifiable work component involving bony decompression and manual reduction of a dislocation. If instead a degenerative or chronic subluxation is reduced as a consequence of posterior wire fixation, it may not be separately reportable.