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TLIF- non contiguous levels

Nicole Posted Fri 10th of August, 2018 14:38:57 PM
If a patient had a TLIF done at L2-L3 and L5-S1. PEEK cages placed in the interspace packed with structural allograft along with morselized allograft. The interspinous ligament was then taken and interspinous plate was placed. Fluoroscopic visualization used. Would these codes be appropriate: 22633 (L2-L3), 22842, 22634 (L5-S1), 22853 x2, 20931, 20930, 77003
SuperCoder Answered Mon 13th of August, 2018 04:40:53 AM

For TLIF lumbar region, CPT 22633 or 22630 is appropriate, there is difference of approach in both the codes, CPT 22630 is done through posterior interbody technique, whereas, CPT 22633 is done through combined posterior or posterolateral technique with posterior interbody technique; check your procedure technique and select the code accordingly. CPT +22634 is correct for additional interspace and CPT +22842 for posterior segmental instrumentation, just make sure this procedure is done for 3 to 6 vertebral segments. CPT 22853 is appropriate for insertion of interbody biomechanical device(s), append 2 units only when it is performed at the two levels and mentioned in the medical document. For structural allograft and morselized allograft, CPT 20931 and 20930 are correct respectively. CPT 77003 can be used for fluoroscopic guidance spinal procedure.

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