Wiki Of X-Stop and Dural Tears.....

[caromissunc1]

The patient has had an X-Stop in for approximately 18 months, when the surgeon decided to remove the X-Stop, and instead, perform a 2 level TLIF with instrumentation. Should the X-Stop removal be coded since it had to be removed to insert the TLIF? Or no?
Meanwhile, back at the ranch, an incidental dural tear was done and an intrathecal catheter inserted for CSF leak. Should either the tear or the catheter insertion be coded?
I have come to y'all in the past and been WAY satisfied. Thanks in advance for this one!

 

[penguins11]

If he is removing the instrumentation and reinserting at the same level, I would use 22849. I would not bill for the dural tear repair, we have always been told that the procedures are valued for a certain amount of complication. Plus if the surgeon tears it, he should repair it.