Orthopedic Coding Alert

Question: If the surgeon fuses vertebrae L1 through L3, should I report 22612, 22614; or 22612, 22614 x 2?

Wyoming Subscriber

Answer: You should report 22612 (Arthrodesis, posterior or posterolateral technique, single level; lumbar [with lateral transverse technique when performed]) along with a single unit of +22614 (... each additional vertebral segment [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 intervetrebral disk (in other words, two segments and the interspace between them).

In your case, the surgeon is fusing segment L1 to segment L2 (22612) and segment L2 to segment L3 (+22614). Although the procedure involves three vertebrae, the surgeon only performs two fusions.