Wiki Fusion/decompression T12 - L4

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kwinters

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Hi all!

Just want to confirm I have the correct codes for this procedure. Provider did a posterior lumbar decompression/fusion at levels T12-L4. Here are the codes I came up with:

22610 - T12-L1
22614 x3 - L1-4
63046 - T12-L1
63048 x 3 - L1-L4

22842
22853 x 4 T12-L4

I'm pretty new at spine coding and want to make sure I have this correct. I've attached the operative note as well. Any help would be greatly appreciated!

TIA
 

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  • OP REPORT 10-6-22.pdf
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I read this as a posterior interbody fusion due to placement of rods. 22853 code is for cages or mesh
So check out
22610 thoracic there isn't a interbody fusion for thoracic
22630 arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace, single interspace lumbar
22632x2
22842 3-6 vertebra posterior segmental
20931 allograft machined structural
20936 autograft localized same incision

might consider a 22 mod for mentioned additional hour to expose and decompress due to high BMI and thick epidural scar tissue

found this it is from 2019 so also follow you current clinics or guidelines but is good education on the spine:


CMS coding policy
 
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Agree with Nichole and would add to make sure to code obesity with the BMI so that it supports your -22 modifier. Helps the claim process possibly without having the lag for a medical record review.
 
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nickelclaw said:
I read this as a posterior interbody fusion due to placement of rods. 22853 code is for cages or mesh
So check out
22610 thoracic there isn't a interbody fusion for thoracic
22630 arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace, single interspace lumbar
22632x2
22842 3-6 vertebra posterior segmental
20931 allograft machined structural
20936 autograft localized same incision

might consider a 22 mod for mentioned additional hour to expose and decompress due to high BMI and thick epidural scar tissue

found this it is from 2019 so also follow you current clinics or guidelines but is good education on the spine:


CMS coding policy
Click to expand...
Thank you so much for reviewing the op note & for the codes. I have bookmarked the helpful links you sent as well as I'm sure I will be referring to quite often.
 
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