Neurosurgery Coding Alert

Question: Which CPT code describes TLIF? Pennsylvania Subscriber Answer: For a transforaminal lumbar interbody fusion, or TLIF, you should select 22630 (Arthrodesis, posterior interbody technique, including laminectomy and/or diskectomy to prepare interspace [other than for decompression], single interspace; lumbar) for the first interspace the surgeon fuses, with add-on code + 22632 (- each additional interspace [list separately in addition to code for primary procedure]), as required, for each additional lumbar interspace the surgeon fuses beyond the first. TLIF describes an alternative to other fusion methods, such as anterior lumbar interbody fusion (ALIF) and posterior lumbar interbody fusion (PLIF), and may offer advantages over those approaches for some patients. You would report a PLIF using the same codes as for a TLIF (22630 and 22632). For an ALIF, however, you would access 22558 (Arthrodesis, anterior interbody technique, including minimal diskectomy to prepare interspace [other than for decompression]; lumbar) and +22585 (- each additional interspace [list in addition to code for primary procedure]). Remember, also, that CMS and CPT guidelines allow you to report spinal bone grafting (+20930-+20938) and spinal instrumentation (+22840-+22848, +22851) separately with arthrodesis procedures. Learn more: For complete information on reporting arthrodesis codes and related procedures such as spinal bone grafts and instrumentation, see "3 Questions Reveal Your Ideal Arthrodesis Code," Neurosurgery Coding Alert, Vol. 9, No. 7, pages 49-53. -- Technical and coding guidance for You Be the Coder and Reader Questions provided by Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison.