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  • Posted by 30365, 1 year ago. There are 4 posts. The latest reply is from SuperCoder.
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  1. Dr. performed removal of old instrumentation at L4-S1 and new pedicle screw fixation L3-L4. Can we bill for 22850 and 22840?

  2. New instructions under the Spinal Instrumentation subsection have been revised and broken down into three categories:

    •Removal (22850, 22852, 22855): use when taking out hardware and not when insertion or reinsertion is performed
    •Reinsertion (22849): use when hardware is going back in at the same levels/location (i.e., failed hardware) and includes removal (22850, 22852, 22855)
    •Insertion (22840-22848): use when new hardware is put in which "exceeds" the previously placed hardware and includes removal (22850, 22852, 22855)

    In your case insertion and removal is at different levels, hence 22850 and 22840 is appropriate.

  3. Thank you. Even if reinsertion is not at the same levels, but same general location?

  4. Code 22849 specifies -reinsertion.- You can't reinsert a device without having removed a previously inserted device. Therefore removal (22852) is integral to reinsertion (22849), and you should report only 22849 when the surgeon performs both at the same level.

    Code 22850 is a column 2 code for 22840 , but a modifier is allowed in order to differentiate between the services provided.
    *Use modifier with code 22850

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