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Charlene Posted Thu 12th of October, 2017 11:49:19 AM
UP COMING SURGERY: Three new ACDF levels and removal of previously placed bone graft which was used for previous fusion rather than a spacer. The graft has failed to fuse. Which cpt is appropriate for the removal of old bone graft?
SuperCoder Answered Fri 13th of October, 2017 02:33:24 AM


As per coding guidelines, appropriate code as per above documentation would be chosen from CPT code series 20930-20938 which includes removal as well as insertion of graft or other implants and these are add-on codes which will be used with ACDF code series 22551 to 22554 if graft placement is performed at the same level as ACDF. But in above documentation, it is mentioned that graft removal was at different level, so it is not clear from the documentation provided what else was done other than removal of graft on that particular site, so it would be difficult to mention you the exact CPT.


Charlene Posted Fri 13th of October, 2017 13:50:54 PM
Some time ago the pt had a one level ACDF using bone graft not a spacer. Upcoming procedure will be 3 level initial ACDF adjacent to previous failed fusion by bone graft. My provider says the removal of previous bone graft will greatly add to the case and will be followed by spacer insertion into the same space. What CPT would be used for bone graft removal?
SuperCoder Answered Mon 16th of October, 2017 02:59:12 AM


According to the above scenario, the appropriate CPT code would be 22845 since done at three vertebral segments. Removal of bone graft will not be payable separately and will be inclusive to insertion of bone spacer, CPT code 22845.


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