Wiki 22845 Instrumentation Documentation

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Mcminnville, OR
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Hello,

I keep getting denials from a specific insurance company about the documentation not being on the operative report for 22845. Generally this code is billed with 22551, 22846, 22851 & 20930. No modifiers are on any line item. The operative notes usually state something along the lines of "placement of an anterior cervical plate, 48-mm Skyline ridge plate with 14-mm self taping screws." (this is documented after the anterior arthrodesis and peek cage. Am I missing something? The documentation seems very clear cut to me.
 
I have trouble with this with 1 commercial plan, I always appeal (can't perform arthrodesis without the hardware!). I believe this is a problem with the scrubber the insurance company uses because we always win the appeal. This same insurer will also deny when I bill 22552 with 22551 - very frustrating but worth the appeal.
 
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