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REVISION SPINE SURGERY

Diane Posted Fri 07th of August, 2015 11:58:55 AM

My dr. did a revision of lumbar spine fusion due to a displaced PEEK implant which the implant was impacted further down at which time it was found to be in good position, so it was a re-positioning of the implant. What code should I use for this? THe plates and screws had to be removed to achieve this, this was at the L5-S1 level. Also he did external neurolysis at L5-S1.
He did bilateral laminotomies at L-3 with discectomy at L3-4. Then bilateral PLIF with PEEK implant and stabilization with plates and screws at L3-4.
THen he did lateral mass fusion L3-S1.
I have codes 63030-50-59 for the laminotomy at L3-4
22852 for the removal of plates and screws at L5-S1
64714 external neurolysis L5-S1
22633 PLIF/lateral mass fusion at L3-4 22634 PLIF/;lateral at L4-5 22634 PLIF/lateral at L5-S1 Do I have this correct? What code for repositioning?

SuperCoder Answered Mon 10th of August, 2015 01:51:38 AM

CCI edits show bundling of CPT 63030 into 22633. So you can only bill CPT 63030 separately with -59 modifier, if your documentation support that decompression was also performed at L3-L4 level other than work done for fusion. Bill CPT 64714 with -59 modifier. Rest codes are correctly billed. Also, there is no such code for re-positioning of PEEK cage. SO you should bill it as inter-body fusion as you are billing.

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