n Socioeconomics & Politics | Coding
2017 Edition of Common Coding Scenarios for
Comprehensive Spine Care Available!
2017 Common Coding Scenarios for Comprehensive Spine Care includes medical and
surgical coding vignettes, key components to include in the procedure notes and
proper coding of spine procedures for 2017.
n Updated CPT® codes to reflect recent
n CPT® codes for Evaluation and
n CPT® codes 22000 series, 63000 series and
n CPT® codes for Injection, Pain
Management, Radiology and
n 2017 Medicare Physician Fee Schedule
n Ambulatory Surgical Centers (ASC) list of
For more information and to order this
essential coding resource, please visit www.
spine.org or call NASS toll free at 866-960-NASS (866-960-6277).
versus corpectomy for extradural intraspinal lesions (abscess, tumor, osteomyelitis – 63300-63008), versus corpectomy for intradural intraspinal lesions
(abscess, tumor, other – 63304-63308).
There is no separately reportable CPT
code for fracture reduction via anterior
approaches (there is one for posterior
reduction of fracture). Both decom-pression-related and fracture-related
anterior approaches represent generally
similar considerations and thus both are
covered by the 63081-63091 family.
Fluoroscopy used to localize levels
and to verify placement of implants is included in the code, and is not separately
billable for this or any other spine code.
Use of microscope (69990), if microscopic technique is used, is separately
billable in corpectomies.
Co-Surgeons: - 62
If an approach surgeon is used for access
to the anterior spine (example: vascular
surgeon provides access to L3-L5 via an
anterior approach), then modifier 62 is
appended to the corpectomy code. Both
the spine surgeon and the approach surgeon share the value of the code’s work,
and both add 62 to the code for billing
purposes, with each surgeon providing
a separate dictation detailing the distinct
work he/she contributed.
In addition to the insertion of interbody
device as above, separate anterior in-
strumentation may be applied (example:
plate/screws). Anterior instrumentation
of the spine is denoted by the ability of
the instrumentation to separately sta-
bilize the spinal segment(s) as a stand-
alone device, without the cage present,
such as an anterior cervical or anterior
lumbar plating. If separate anterior in-
strumentation is used (in addition to
the anchoring device), it is appropriate
to separately code and bill for both the
interbody device and the anterior instru-
mentation as these are both reimburs-
able procedures. In other words, while
the insertion of an anchoring screw or
flange to hold the intervertebral device
in place is bundled into the procedures,
separate anterior instrumentation
which extends to vertebra above and
below the inserted device is not.
When used and appropriately documented, stereotactic image-guidance is
separately billable for the spine, 61795.
The patient’s radiographs are merged
with software reconstructing the spinal
imaging on a computer, allowing for
20936 Autograft, same skin/fascial
incision, for morselized or
20937 Autograft, via a separate skin/
fascial incision, morselized
20938 Autograft, via a separate skin/
fascial incision, structural graft
20930 Allograft for spine, morselized,
or placement of osteopromo-
20931 Allograft for spine, structural
In Contrast ...
In contrast to anterior corpectomy is
the anterior discectomy, where the
code describes a single disc removal to
prepare the interspace and decompress
the neural elements. The associated
interbody device for single disc space is
coded with 22853, as of January 1, 2017.
Among the most common spinal
procedures coded is 22551—the bundled anterior cervical discectomy and
fusion code includes the access to the
front of the spine, discectomy, endplate
preparation, osteophytectomy, and
the microscope the surgeon may/not
choose to use. The most commonly
performed together codes of 22554 and
63075 and 69990 were bundled together
effective January 1, 2010. The anterior
discectomy goals reflect the work in and
around each disc space, in a horizontal
concept, and should not be described
as a partial corpectomy. This particular
phrasing is ripe for insurance denial for