November 16, 2023 Question: Is it best practice to bill 99202-99215 based on time only? Answer: CPT Codes 99202 to 99215, history and physical examination will no longer be a key factor in determining your level of coding. Instead, coding will be dependent on: Levels of medical decision making applied during the service OR Total...
November 2, 2023 Question: If percutaneous rods and screws are placed without a parent or primary code, for example as a staged procedure a different day after an ALIF or as the sole treatment for a vertebral fracture. I understand an unlisted code (22899, Unlisted procedure, spine) must be reported. What should be used as...
October 19, 2023 Question: What if we the neurosurgeon places percutaneous screws and rods (no posterior fusion/bone graft) as the sole treatment for a vertebral fracture. Do we code the regular posterior instrumentation codes, for example +22840 or +22842? Answer: Unfortunately, no. Placement of percutaneous screws and rods as the sole procedure must be reported...
October 5, 2023 Question: What if we do the surgeon does an ALIF, 22558 on one day then the second day the only procedure is placing a percutaneous screws and rods (no posterior fusion/bone graft). Do we bill +22840-58 on the second day? Answer: Placement of percutaneous screws and rods is reported using the usual...
August 3, 2023 Question: I placed posterior percutaneous screws and rods without an arthrodesis. I know I have to use an unlisted code, 22899. How should I price it? Answer: Good question. Let’s assume you’re doing +22842 (posterior instrumentation, 3-6 segments) which is an add-on code. Add-on codes are valued for only the intra-operative portion...
July 20, 2023 Question: I placed posterior percutaneous screws and rods without an arthrodesis, the day after an ALIF. Should I bill 22842, it was segmental, 3-6 segments spanned, and a 58 modifier? Answer: Code 22842 is for open segmental instrumentation. Most importantly, it is an add-on code and can only be reported with a...
July 6, 2023 Question: For a patient with a diagnosis of lumbar radiculopathy, the surgeon performed a L3-L4 laminectomy with bilateral foraminotomy. She also removed some disc at the same level. Can both 63047 and 63030-59 be billed? Answer: For a laminectomy at a single interspace/motion segment, only one code may be reported. In the...
June 8, 2023 Question: What are the most appropriate codes for venous stenting for a patient with intracranial hypertension? Answer: There is no specific CPT code for intracranial venous stenting. An unlisted code 64999 should be reported in addition to second order venous catheterization, 36012 and the venogram , most typically 75870, venography superior sagittal...
May 25, 2023 Question: The neurosurgeon documents a placing a cervical “facet implant or intrafacet implant “ with bone graft. Is this coded as 22600, cervical arthrodesis? Answer: No. This is coded with a Category III code, as shown below: Facet Wedge or Dowel Arthrodesis (Intrafacet Implant) Placement of a posterior intrafacet implant(s), unilateral or...
