Here is what I am coming up with
22595 for the arthrodesis C1 to C2 posterior
here is coder desk reference description of 22595:
Spinal arthrodesis, or fusion, may be done for conditions of herniated disc, degenerative, traumatic, and/or congenital lesions, or to stabilize fractures or dislocations of the spine. The patient is placed in a Stryker frame with a previously applied halo vest. The physician makes an incision from the occiput to the fourth or fifth vertebra. The physician exposes the posterior arch of the atlas (C1) and laminae of the axis (C2) and removes all soft tissue from bony surfaces. The upper arch of C1 is exposed and a wire loop is brought from below upward under the arch of the atlas and sutured. The physician passes the free ends through the loop, grasping the arch of C1. A graft taken from the iliac crest or other donor bone is placed against the lamina of the C2 and the arch of C1 beneath the wire. The physician passes one end of the wire through the spinous process of C2 and twists it securely into place. The retractors are removed and the incision is closed over a drain.
22600 for arthrodesis C3
22843 for posterior instrumentation per segment which included C1-T2 total of 9 segments
CDR description for code range 22842-22844
Segmental instrumentation is a construct placed with fixation not only at either end but also at the levels between. The physician makes a midline incision in the skin, fascia, and paravertebral muscles over the affected vertebrae. Multiple hooks or screws are introduced into the vertebral pedicles where fixation is needed. Dual rods, such as Harrington distraction and compression rods, are anchored to the screws or hooks. Distraction is the force that produces kyphosis and compression corrects kyphosis, the abnormal hunchback curvature of the spine. To achieve correction, the compression assembly is tightened in place before distraction is applied and secured in position. The wound is closed with layered sutures. The Harrington rod instrumentation techniques are being replaced by three-dimensional correction techniques where rods can be bent along the length and applied at any level, in rotation, with distraction and compression applied between segments. Report 22842 for fixation of three to six vertebral segments; 22843 for seven to 12 vertebral segments; and 22844 for 13 or more vertebral segments. These codes are reported in addition to codes for the primary procedure.
20930 for allograft
Wouldn't get credit for removal since this was a revision.
If the removal was replaced at the same levels with no additional then code 22849
22849
This code describes the procedures used following failure of devices such as wires, screws, cables, plates, or rods used in spinal fixation. The patient is placed in the position dictated by the failure. The physician makes a midline incision overlying the damaged section. The fascia, paravertebral muscles, and ligaments are retracted. A number of reparative techniques may be used, depending on the device and point of failure. In most cases, the device must be replaced. The physician closes the muscles, fascia, and skin with layered sutures.
I am a facility coder so I normally don't code the monitoring can't help there
