Neurosurgery Coding Alert

Question: If the physician did posterior arthrodesis for achondroplasia and recurrent stenosis from T12-ilium and a fusion for S1-ilium. How do we report this?

Alaska Subscriber

Answer: There is insufficient detail to provide exact coding guidance. Posterior lumbar fusion is reported with 22612 (Arthrodesis, posterior or posterolateral technique, single level; lumbar [with lateral transverse technique, when performed]) for the initial level and 22614 (Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment [List separately in addition to code for primary procedure]) for each additional level down to and including the sacrum. A posterior fusion from T12 to the sacrum is reported with 22612 and five units of 22614. A sacroiliac arthrodesis is reported with 27280 (Arthrodesis, sacroiliac joint [including obtaining graft]) for unilateral fusion of the sacroiliac joint. Note that the code 27280 includes the work of obtaining the graft. If this is performed bilaterally, you should append the 50 (Bilateral procedure) modifier.