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Neurosurgery Coding Alert

Reader Questions:

Don't Lose Out on Additional PLIF Reimbursement

Published on Mon Mar 27, 2006

Question: Is it appropriate for me to report both 22630 and 22612 for lumbar fusions that my neurosurgeon performs?


Alabama Subscriber


Answer: If the neurosurgeon performs both a -basic- posterior lumbar interbody fusion (PLIF) and a posterolateral fusion, you should report both codes.

Report a basic PLIF procedure using just code 22630 (Arthrodesis, posterior interbody technique, including laminectomy and/or diskectomy to prepare interspace [other than for decompression], single interspace; lumbar).

But if the physician also performs a posterolateral fusion, report 22612 (Arthrodesis, posterior or posterolateral technique, single level; lumbar [with or without lateral transverse technique]) as the primary code. Then, report 22630 as an additional procedure. Append modifier 51 (Multiple procedures) to indicate that the posterolateral fusion was a secondary procedure that your neurosurgeon performed during the same operative session.  
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