Neurosurgery Coding Alert

Question: Our surgeon performed anterior cervical discectomy at C3-C4, C4-C5, and C5-C6. He completed fusion at the same levels with cervical plating for C3 through C6. Do the vertebrae fall into the "2-3 segments" or "4-7 segments" category?

Wisconsin Subscriber

Answer: When coding spinal instrumentation, you should count per vertebra. Treating C3, C4, C5, and C6 qualifies as four segments, so you'll report +22846 (Anterior instrumentation; 4 to 7 vertebral segments [List separately in addition to code for primary procedure]) in addition to the procedure code. If he treated fewer vertebral segments you would choose +22845 (... 2 to 3 vertebral segments [List separately in addition to code for primary procedure]).