emeskina
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Spinal arthrodesis redo with removal/replacement of interbody graft & instrumentation
PROCEDURE PERFORMED: 12/12/18
1. Left-sided L3-4 transforaminal lumbar interbody fusion using local autograft bone and allograft bone extender (Infuse).
2. Left-sided L4-5 transforaminal lumbar interbody fusion using local autograft bone and allograft bone extender (Infuse).
3. Right-sided L4-5 Gill type osteotomy for nerve root decompression.
4. Placement of biomechanical intervertebral device at L3-4.
5. Placement of biomechanical intervertebral device at L4-5.
6. L3-L5 pedicle screw and rod fixation.
Pt experienced multiple falls; last being 1/9/19 when pt presented to hospital. Second procedure performed same day:
PROCEDURE:
1. Revision left-sided L4-5 transforaminal lumbar interbody fusion using allograft bone and infuse.
2. Placement biomechanical intervertebral device at L4-5.
3. Revision multisegmental instrumentation L3-L5.
Surgeon describes displacement of interbody device and segmental instrumentation screws. After removing same, he cleans the L4-5 intervertebral space of previous grafting material and, with the exception of the laminectomy, basically repeats 22633 and 22853 and 22842.
I'm leaning toward codes 22849 and 22633 with modifiers 76 and/or 78 attached. Thoughts???
Thanks in advance for your time!
Erin E
PROCEDURE PERFORMED: 12/12/18
1. Left-sided L3-4 transforaminal lumbar interbody fusion using local autograft bone and allograft bone extender (Infuse).
2. Left-sided L4-5 transforaminal lumbar interbody fusion using local autograft bone and allograft bone extender (Infuse).
3. Right-sided L4-5 Gill type osteotomy for nerve root decompression.
4. Placement of biomechanical intervertebral device at L3-4.
5. Placement of biomechanical intervertebral device at L4-5.
6. L3-L5 pedicle screw and rod fixation.
Pt experienced multiple falls; last being 1/9/19 when pt presented to hospital. Second procedure performed same day:
PROCEDURE:
1. Revision left-sided L4-5 transforaminal lumbar interbody fusion using allograft bone and infuse.
2. Placement biomechanical intervertebral device at L4-5.
3. Revision multisegmental instrumentation L3-L5.
Surgeon describes displacement of interbody device and segmental instrumentation screws. After removing same, he cleans the L4-5 intervertebral space of previous grafting material and, with the exception of the laminectomy, basically repeats 22633 and 22853 and 22842.
I'm leaning toward codes 22849 and 22633 with modifiers 76 and/or 78 attached. Thoughts???
Thanks in advance for your time!
Erin E