Wiki Recoupment on 22633 if minimally invasive technique is used?

[lford@qcora.com]

Does anyone have any guidance on this situation? I am relatively new to spinal surgical coding and cannot find any guidance that indicates that a minimally invasive technique should be coded differently from the open? But we've received a couple post review recoupments saying that 22633 does not cover MI and I've been at this for days trying to find support one way or the other.

Thank you!

 

[cappa412]

Is the minimally invasive procedure using both:
-a posterior or posteriolateral technique
-a posterior interbody technique

Are you coding this CPT for the interspace to be prepared for another procedure?

Is this being billed for purposes other than decompression?

That's the checklist from the code description.

I can't help much more without examples or redacted documentation. You're most likely looking at something like 22612 for posterior or posterolateral fusion with 63020 keyhole laminotomy/foraminotomy (they don't bundle). Coding both of those is not the same as coding 22633, but again, really going blind here without an example.

Thanks

 

[amyjph]

As stated above it is difficult to know without seeing a redacted op note to see if the coding was correct or not from the start.
22633 is posterior w/ posterior interbody, lumbar (combined tehcnique). Commonly you would see the acronym TLIF. Sometimes you will see them state the words combined like the code description.
22630 is posterior interbody (missing the w/ posterior).

Have you checked the payer policy on minimally invasive techniques?
This is old and only an example, but most of the policies would be named something like this if the payer has one: https://www.aapc.com/codes/webroot/upload/general_pages_docs/document/182.pdf
Another example policy: https://www.uhcprovider.com/content...cal-drug/minimally-invasive-spine-surgery.pdf

Did you check CPT Assistant?

This is old but a good article. https://www.healio.com/news/orthope...-type-of-spine-surgery-impacts-code-selection