Wiki Corpectomy w/Arthrodesis

Hi
If the Dr is doing an Arthrodesis C4-C5 and C5-C6, Corpectomy C5-C6
Would I bill it as 22554 C4-C5, 22585 C5-C6, 63081 C5-C6

Please help

Correct - A corpectomy is a resection of a vertebral body, not an interspace. You likely mean to say a C5 corpectomy. In this case 63081 includes the decompression of both disc spaces and the bony resection. This leaves only a single span to be fused, from C4-6, but the number of fusion codes is based on the preprocedure anatomy, so you would correctly code 22554 and 22585.

NRaizman said:

Correct - A corpectomy is a resection of a vertebral body, not an interspace. You likely mean to say a C5 corpectomy. In this case 63081 includes the decompression of both disc spaces and the bony resection. This leaves only a single span to be fused, from C4-6, but the number of fusion codes is based on the pre procedure anatomy, so you would correctly code 22554 and 22585

Click to expand...

Have you ever seen 22551 C4-C5 , Corpectomy 63081 C5. C5-C6-22554
22551 C4-C5
22554 C5-C6
63081 C5

cynsteve04@aol.com said:

Have you ever seen 22551 C4-C5 , Corpectomy 63081 C5. C5-C6-22554
22551 C4-C5
22554 C5-C6
63081 C5

Click to expand...

That would be inappropriate.
The work of corpectomy (63081) includes any and all resection of bone - both osteophytes and the vertebral body - decompression of the nerve roots and spinal canal, and the removal of the discs on either side. You may not code 22551 in conjunction with 63081 with reference to the same involved levels. This was spelled out in CPT-A, by the way, in 2023. A C5 corpectomy would include everything that differentiates 22551 from 22554 as integral to that procedure.

In order to bill a corpectomy, you must resect a bare minimum of 50% of the vertebral body. Corpectomies are indicated in the setting of cervical spondylotic myelopathy, but there are spine surgeons who may be billing for them inappropriately. If they do not document that they have resected at least 50% of the vertebral body, or if postoperative radiographs are inconsistent with that level of resection, I would be skeptical.