Neurosurgery Coding Alert

Question: How do we code arthrodesis for deformity and PLIF, L2- S1 fusion with L4-S1 interbody fusion?

New Jersey Subscriber

Answer: There is insufficient information to provide specific coding guidance in this example. It appears from the brief summary that a two level posterior lumbar interbody fusion is performed (L4-5 and L5-S1), which would be reported with 22630 and 22632. Although not specifically described, the L2 to S1 fusion likely represents a concurrent posterolateral fusion, which would be reported with 22612 and 22614x3 for the L2-3, L3-4, L4-5, and L5-S1 levels fused. Bone graft harvest and instrumentation codes may be separately reportable, if performed. If the surgery represents treatment of a pediatric deformity, one should instead consider 22800 for the posterior arthrodesis of 4-6 segments for deformity.