Wiki 22633 with 22612

[amatlack]

I attended 2 spine surgery classes @ the 2012 conference and both instructors advised that if our surgeon performs a combined arthrodesis/interbody arthrodesis on the first lumbar level coded as 22633 then only performs arthrodesis at the next lumbar level we cannot bill 22612 because it is included in the primary code 22633 and that each additional level must be coded as 22614. My surgeons are arguing that since this is at a different lumbar level they can in fact bill the 22612. I cannot find the LCD to prove this just is not so. Am I wrong or is there backup documentation to prove that what I was taught at the conference is correct. I am in Washington state so must use the Noridian Medicare site. I have spent countless hours trying to find any back-up to support this. Any help would be greatly appreciated.

Thanks mucho!

Ann Matlack,CPC
Olympia Wa

 

[Nat]

22612 vs 22614

The 22612 and 22633 are primary procedures. That is why you must use the 22614, 22634 for other levels.

Have you checked the AMA or AAOS websites? I would recommend trying them.

 

[DevonaG]

ok but what if the surgeon does a separate incision that involves a fusion and interbody (22633) at L5-S1 but fuses from T10-L3 again separate incisions?? can i not bill a 22610 for T10-T11??