Can someone help me out here? I am having some trouble agreeing with my neurosurgeon on how to code one of his ACDF's
Please see the procedure below:
Procedures Performed:
1. Removal of C4, 5, and 6 anterior instrumentation
2. C3-4 anterior diskectomy
3. C3-4 anterior interbody arthrodesis
4. C4-5 revision anterior interbody arthrodesis
5. Reoperation left iliac crest tricortical structural allograft harvest x2
6. Preparing iliac crest tricortical graft for an insertion at C3-4 and C4-5
7. Anterior instrumentation C3, 4, 5, 6
This is how he wants it coded:
22551
63081 (or unlisted procedure code here)
22846
22855
20938
I do not agree. I believe it should be coded around these lines:
63081
22551-51-59
22849-59
22845
22853
20938
He does not agree with code 22849 because he states that was not the procedure performed. He thinks we should not use this code because we added a level to the arthrodesis. Would I have to code the 22849 for the levels that are being removed and reinserted (he is not using the same instrumentation at all)? and code 22551 for the new level done?
He consistently wants me to use an unlisted procedure code for redos of different operations as opposed to using the actual code with the appropriate modifiers. I cannot seem to get unlisted procedure codes paid, therefore i do not want to use them. Any help is greatly appreciated!! We've been over this so many times now my brain just feels like mush and I cannot even begin to think how to code this!
Please see the procedure below:
Procedures Performed:
1. Removal of C4, 5, and 6 anterior instrumentation
2. C3-4 anterior diskectomy
3. C3-4 anterior interbody arthrodesis
4. C4-5 revision anterior interbody arthrodesis
5. Reoperation left iliac crest tricortical structural allograft harvest x2
6. Preparing iliac crest tricortical graft for an insertion at C3-4 and C4-5
7. Anterior instrumentation C3, 4, 5, 6
This is how he wants it coded:
22551
63081 (or unlisted procedure code here)
22846
22855
20938
I do not agree. I believe it should be coded around these lines:
63081
22551-51-59
22849-59
22845
22853
20938
He does not agree with code 22849 because he states that was not the procedure performed. He thinks we should not use this code because we added a level to the arthrodesis. Would I have to code the 22849 for the levels that are being removed and reinserted (he is not using the same instrumentation at all)? and code 22551 for the new level done?
He consistently wants me to use an unlisted procedure code for redos of different operations as opposed to using the actual code with the appropriate modifiers. I cannot seem to get unlisted procedure codes paid, therefore i do not want to use them. Any help is greatly appreciated!! We've been over this so many times now my brain just feels like mush and I cannot even begin to think how to code this!