Neurosurgery Coding Alert
Report Arthrodesis per Interspace, Not per Level
Question: The surgeon performed anterior fusion from L1 to L3. We reported one unit of 22558 and two units of 22585. The payer rejected the claim. Why?
Tennessee Subscriber
Answer: The descriptors for codes 22558 (Arthrodesis, anterior interbody technique, including minimal diskectomy to prepare interspace [other than for decompression]; lumbar) and +22585 (... each additional interspace [list separately in addition to code for primary procedure]) specify "interspace" rather than "level." CPT clearly defines a segment as "the basic constituent part into which the spine may be divided. It represents a single complete vertebral bone with its associated articular processes and laminae."
In this case, report one unit of 22558 with just one unit of 22585 because L1-L2 is one interspace and L2-L3 is another. Although L1, L2 and L3 constitute three vertebral bodies, the surgery only addresses two interspaces.
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