Neurosurgery Coding Alert

Question: Our neurosurgeon placed one plate at C3-5 and a second plate at C6-7. How do we code this procedure?

Alabama Subscriber

Answer: As long as your surgeon documents a healthy interspace between the areas, you can bill the plate placements as two separate procedures:

• +22845 -- Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)

• +22845-59 -- ... Distinct procedural service.

No primary code: Although +22845 is considered to be an add-on code, you can report it twice, with one  appended by modifier 59.According to CPT Assistant (November 2007), "Anterior instrumentation codes 22845-22847 may be reported separately with modifier 59 appended when the procedure involves the work of putting two separate plates in the spine at different locations."