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Neurosurgery Coding Alert

Reader Question:

Spinal Fixation

Published on Wed Dec 19, 2012

Question: Blue Cross/Blue Shield disallowed CPT code 22558 of the following surgery: 22558 (arthrodesis/lumbar), 22851 (application of prosthetic device) and 22855 (removal of spinal fixation), stating that it was “global” and therefore not allowed per their policy. The carrier crossed off other codes (22851 and 22855), stating that they were not allowed per administrative policy. Would you please let us know if the reduction of these codes is correct?
Cheryl Deahn
Northwest Neurosurgical Associates, Tualatin, Ore. Answer: There is nothing inherently wrong with this coding, assuming that the operative report supports the different procedures billed. The problem lies with the national Correct Coding Initiative (CCI) edits. Although it is possible to remove a previous spinal fusion and then reconstruct it at the same session and at the same level, current edits bundle the more extensive procedure code 22558 (arthrodesis, anterior interbody technique, including minimal diskectomy to prepare [...]
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