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Thoracolumbar Fusion

Caralee Posted Mon 08th of August, 2016 01:19:50 AM
Surgeon performed T8 to L2 posteolateral instrumentation fusion with T8 to L1 Laminectomy for thoracolumbar stenosis. If we bill 22612, 22610-59, 22614*4, 63047, 63046-59, 63048 *4, 22843, will it be considered double billing for fusion and laminectomy codes? Should we use only 22612, 22614*5, 63047, 63048*5, 22843? Thank you.
SuperCoder Answered Fri 12th of August, 2016 03:23:24 AM


For laminectomyof T8-L1 posterolateral technique the most appropriate code seems to be CPT 63047, 63048*4 and for arthrodesis T8-L2, CPT 22612, 22614*4. "If an arthrodesis crosses over both the thoracic and lumbar locations, it is recommended that you report 22612 as the primary arthrodesis code for lumbar. CPT and CMS indicate that performing an arthrodesis at the lumbar level requires more work value than one in the thoracic area. (Federal Register 2003—22612 has a work relative value unit [RVU] of 20.97; 22610 has a work RVU of 16.00)"

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