Neurosurgery Coding Alert

Question: If the surgeon fuses vertebrae L1 through L3, should I report 22612, 22614, or 22612, 22614 x 2?

Utah Subscriber

Answer: You should report 22612 (Arthrodesis, posterior or posterolateral technique, single level; lumbar [with or without lateral transverse technique]) along with a single unit of +22614 (... each additional vertebral segment [List separately in addition to code for primary procedure]).

The descriptors for 22600-+22614 can be confusing because they refer to spinal levels rather than spinal interspaces. Arthrodesis reflects a fusion of a motion segment, however, and a motion segment refers to two adjacent vertebrae and the intervetrebral disk and/or facet joints between them (in other words, two segments and the interspace/joints between them).

In your case, the surgeon is fusing segment L1 to segment L2 (22612) and segment L2 to segment L3 (+22614). Although the procedure involves three vertebrae, the surgeon performs only two locations of fusion.