Neurosurgery Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Question: When I report 63075 and 22554 together, 63075 is denied. This isn't a CCI edit, so why is 63075 not paid?

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Answer: You're correct. The national Correct Coding Initiative (CCI) does not bundle 63075 (Diskectomy, anterior, with decompression of spinal cord and/or nerve root[s], including osteophytectomy; cervical, single interspace) to 22554 (Arthrodesis, anterior interbody technique, including minimal diskectomy to prepare interspace [other than for decompression]; cervical below C2). But the CPT definition for 22554 does specify "including minimal diskectomy." Your payer may be using a "black box" edit to screen for such claims in an attempt to avoid paying separately for minimal diskectomy inappropriately billed with 22554. Assuming the diskectomy was, indeed, more than minimal (for instance, it included a decompression), you are correct to report 63075 in addition to 22554, and the payer should reimburse for both procedures. If the carrier rejects the claim, improve your documentation by specifically noting that the surgeon performed more than minimal diskectomy and refile. If payment is still not forthcoming, appeal.