Wiki question on coding 22840

[02093599]

if the provider is doing 2 interspace, does he use the 22840 two times before the 22842 is used for the 3rd interspace? Just wanted to clarify this. thank you

 

[amyjph]

No. 22840 is non-segmental meaning the instrumentation goes across one interspace like L1-L2. If the provider is doing more than 2 vertebral segments (segmental instrumentation) you go to cpt 22842 (3-6) or 22843 if it's 7-12. 22840 is not reported more than once.
So, if they are doing a posterior lumbar fusion from L1-L5 it is 4 (L1-L2, L2-L3, L3-L4, L4-L5) so you would report 22842. You can't code both 22840 & 22842 together it doesn't make sense. Read the spinal instrumentation information at the start of the 22840-22855 section in the book. It also should have diagrams. It defines segmental and non-segmental as well as what a segment and interspace is. There could be cases where you would report 22840 where the instrumentation spans more segments if the fixation is only at the top and bottom but not attached to each individual segment between (I have never seen this but it "could" happen).