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interspinous process clamp

Caralee Posted Wed 05th of April, 2017 00:06:34 AM
Please provide coding guides for removal of interspinous process clamp. Pt. had interspinous process clamp placed previously. Surgeon removes the interspinous process clamp at L4-L5 and performs lumbar interbody fusion at that level. How would I code removal of interspinous process clamp and insertion of cage at the same L4-L5 level. Thanks.
SuperCoder Answered Thu 06th of April, 2017 09:30:15 AM

Hi,

CPT code 22630 is recommended for lumbar fusion.

Also, below are the links for removal of interspinous process clamp :

https://www.bcbsnc.com/assets/services/public/pdfs/bluemedicare/medicalpolicy/x-stop.pdf

http://blue.regence.com/medicare/sur/m-sur172.pdf

Caralee Posted Sat 08th of April, 2017 11:53:51 AM
Can we use 22849 for removal of clamp and use of new cage and instrumentation for fusion at the L4-L5 level?
SuperCoder Answered Wed 12th of April, 2017 08:52:14 AM

CPT code 22849 cannot be used for removal of clamp and insertion of cage and instrumentation. CPT code 22849 is for reinsertion of spinal fixation device. Provider removes the faulty component, such as a screw or wire, and replaces it, or more likely, he removes the entire device and replaces it with a new one, using the same attachment sites.

Provider removed the clamp and replaced with cage and instrumentation. There are seperate codes for insertion of cage and instrumentation. Check CPT codes 22840 and 22853. 

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