Neurosurgery Coding Alert

Question: Can you please advise whether we should report the new 2013 CPT^® codes ‘22586’ and ‘0309T’ pre sacral interbody fusion together? What approach (posterior, posterolateral or anterior) are these codes specific for?

Florida Subscriber

Answer: Code  +0309T (Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft, when performed, lumbar, L4-L5 interspace [List separately in addition to code for primary procedure]) is for presacral interbody technique at lumbar (L4-L5) interspace. Code 22586 (Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspace) is used to report arthodesis using presacral interbody fusion technique. 22856 applies only when the surgery is performed at the L5–S1 vertebral interspace. These codes include the utilization of image guidance, disc space preparation, discectomy to remove the diseased disc and posterior instrumentation. Therefore do not report those services separately. You can report 22856 and 0309T together.