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CPT code 22851 x 3 does not apply as the arthrodesis includes this as an element

Shawn Posted Tue 08th of December, 2009 00:10:13 AM

Insurance Company claims that Afthrodesis includes '22851' as an element, and since cannot be billed seperately in the following procedures described in the operatingreport: Posterior segmental spinal instrumentation T10 – S1; bilateral pelvic instrumentation, transforaminal lumbar interbody fusion L3-L4, L4-L5, and L5-S1 with intervertebral devises x3; Posterior posterolateral arthrodesis T10-T11, T11-T12, T12-L1, L1-L2 through L2-L3, L3-L-4, L4-L5, L5-S1 with local autograft and morselized allograft, three large BMP kits.

Is the Insurance company correct?

SuperCoder Answered Tue 08th of December, 2009 07:39:38 AM

In this scenario do you mean to say that for Bone Morphogenetic Protein (BMP)the insurance is denying CPT code 22851. As for BMP (bone morphogenetic proteins), you should not report 22851 for this service. BMP is a special growth factor for the induction of new bone formation. Surgeons mix this product with allograft or autograft bone used during fusion, for instance.
I would suggest CPT code 20931 for BMP. If not then do let me know. Good luck!!

Anna Answered Wed 16th of December, 2009 04:15:29 AM

Actually, BMP is coded as 20930 and if your using 22851 as a implant device such as a cage or PEEK spacer, then our using 22851 correctly.

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