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Toni Posted Tue 09th of February, 2010 13:43:07 PM

Has anyone seen or performed this Interlaminar Lumbar Instrumented Fusion, using ExtenSure allograft, and Affix spinous process plate? It looks like a posterior fusion, with minimal incisions and minimal lamina removal, that uses the allograft spacer and plate. I have some literature saying the spinous process plate would be 22841. (22612, 22841, 20931???) Any feedback for this coding would be appreciated.

SuperCoder Answered Wed 10th of February, 2010 11:46:48 AM

Initially I was a bit hesitant to choose between 22612 and 22630 (for spinal fusion). But as you have mentioned about "minimal incisions and minimal lamina removal", the probable posterior fusion code should be - 22612 (22630 removes out more of lamina / disc). As for "spinous process plate", +22841 would be fine if the Sx is performed on 1-2 lumbar intervertebral discs. If the no. of lumbar segments operated are more like 5-6 or more and if rods-hooks are utilized then the code would become +22842. exact choice of code will depend upon the detailed OP notes. But from the limited info that I can see in the query, I would go with the codes you have chosen, Toni :) i.e. 22612, +22841, +20931. No modifier is required.

Toni Posted Wed 10th of February, 2010 20:18:32 PM

Thank you Apoorba. We have not done one yet but my docs are looking at training for it and wanted me to research it from a coding and payment point of view. They are looking at doing one level lumbar. Nothing I've seen would indicate it would or could be interbody. Sometimes it's just good to have someone else take a look and maybe see something differently. I appreciate the second set of eyes. Toni

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