Neurosurgery Coding Alert

Question: If the surgeon fuses vertebrae L2 through L4, should I report 22612/+22614, or 22612/+22614 x 2?

North Carolina Subscriber

Answer: No. 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 vertebralsegment [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 implies a fusion of a motion segment, however, and a motion segment refers to two adjacent vertebrae and the intercalary disc (that is, two vertebral segments and the interspace between them).

In this case, your surgeon fuses segment L2 to segment L3 (22612) and segment L3 to segment L4 (+22614).Although the procedure involves three vertebrae, the surgeon performs only two fusions.