Neurosurgery Coding Alert
Edits Shouldn't Deny Fusion Removal/Reconstruction Payment
Question: Our surgeon removed anterior instrumentation and reconstructed the lumbar spine using arthrodesis and prosthetic insertion. How can I code this? Answer: Report each procedure as performed: In the past, the National Correct Coding Initiative listed 22558 (arthrodesis) as mutually exclusive of 22855 (instrumentation removal), thereby implying (incorrectly) that a surgeon wouldn't or couldn't remove a spinal fusion and reconstruct it during the same session. Clinical and coding expertise for You Be the Coder and Reader Questions provided by Eric Sandhusen, CHC, CPC, director of compliance for the Columbia University Department of Surgery.
Washington Subscriber
More recently, the NCCI has reclassified this edit as "inactive" and, therefore, payers should honor claims for 22558 and 22855 during the same session.
If your payer denies the claim, be sure to appeal, citing the NCCI edit's inactive status and your documentation as evidence that the claim is legitimate.
Neurosurgery Coding Alert
- Want the Facts on Facet Joint Injections? Look No Further
Count levels treated, not injections, for 64470-64476 When claiming facet joint injections (64470-64476), you should [...] - Don't Forget Fluoroscopic Guidance With Nerve Blocks
If your surgeon provides fluoroscopic guidance that allows her to place the needle for facet [...] - Bill for Wasted Supplies to Save Your Bottom Line
Schedule multiple Botox treatments in same 4-hour block Under Medicare rules, you can receive reimbursement [...] - News in Brief:
AMA May Develop Its Own Correct Coding Initiative
Neurosurgery coders may soon face an additional layer of guidelines, because the American Medical Association, [...] - You Be the Coder:
Can You Report Multiple Spinal Excisions?
Question: The surgeon performed complete laminectomy with decompression and excision of epidural mass at L4, [...] - 4 Steps Will Ease Your 'Unusual Procedure' Claims
When it comes to modifier -22, you have to ask to receive Appending modifier -22 [...] - Medicare Proposes, Rescinds 'Medically Unbelievable' Edits
Regulations would have enacted per-day limits on certain codes If you've heard rumors of a [...] - Reader Questions:
Unlisted-Procedure Code Best for Artificial Disk
Question: Which code should I use to describe placement of artificial disks? I'm leaning toward [...] - Reader Questions:
Destruction Codes Describe RFTC
Question: How can I report the use of radiofrequency thermal coagulation (RFTC) to disable the [...] - Reader Questions:
Global Determines Postprocedure Coding
Question: Following low-back surgery, we had to readmit the patient for a wound abscess. Can [...] - Reader Questions:
Previous Hospital Care May Affect E/M
Question: A provider insurance representative recommended at an in-house seminar that if our surgeon sees [...] - Reader Questions:
Payers Treat Group Practices as 1 Provider
Question: If surgeon 2, in our group practice, provides post-op care for a patient whom [...] - Reader Questions:
Limit -77 to Same Day
Question: One of our surgeons performed a decompressive laminectomy for a patient in 2001. Another [...] - Reader Questions:
Edits Shouldn't Deny Fusion Removal/Reconstruction Payment
Question: Our surgeon removed anterior instrumentation and reconstructed the lumbar spine using arthrodesis and prosthetic [...]
