What is the CPT code for removal of cervical polyp?
There is no separate CPT® code for cervical polyp removal. Some practitioners report polypectomy with 57500* (cervix uteri biopsy) or 57505 (endocervical curettage). If the colposcope is used to identify the polyp base, 57452* can be used to report services. This is answered comprehensively here.
What is the CPT code for cervical disc replacement?
Use CPT 22862 for the revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar. Use CPT 22864 for the removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical.
What is the CPT code for posterior repair?
CPT® Code Code Description Pelvic Floor Repair Procedures - Transvaginal 57240 Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele 57250 Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy 57260 Combined anteroposterior colporrhaphy 57265 Combined anteroposterior colporrhaphy; with enterocele ...
What is the diagnosis code for cervical fusion?
Cervical Posterior Decompression with Fusion— Single Level** 22590, 22595, 22600 Cervical Posterior Decompression (for single level fusion) 63001, 63020, 63040, 63045, 63050 Instrumentation: +22840, +22841 Bone Grafts: +20930, +20931, +20936, +20937 Cervical Posterior Decompression with Fusion— Multiple Levels **
How do you code a cervical discectomy?
+63076 Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace. (List separately in addition to code for primary procedure) Code first (63075).
What is CPT code for anterior cervical discectomy and fusion?
In 2010 and the years prior, the CPT code 63075 was used in concert with 22554 for representing anterior discectomy and subsequent fusion. In 2011, these 2 codes were combined into 1 code: 22551 for first fusion and discectomy level (with code 22552 for additional levels).
What is included in CPT code 22551?
22551—Arthrodesis, anterior interbody, including disk space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2.
What is procedure code 22554?
CPT® Code 22554 in section: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression)
What is the CPT code for Posterior cervical fusion?
The most common outpatient spinal fusion procedure will be on the anterior cervical spine using CPT 22554. On the posterior spine, the more common procedures include the posterolateral fusion (22612) and the interbody fusion (22630).
What is procedure code 22869?
22869. Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or. fusion, including image guidance when performed, lumbar; single level.
What is the difference between 22551 and 22554?
22551 is a newer code, created in 2011. Prior to that, if an ACDF was performed at a single level, you would report 63075 and 22554. Since 2011, if an ACDF is performed at a single level, you report 22551 only.
What is the CPT code for cervical laminectomy?
Use CPT 63045 for cervical or CPT 63047 for lumbar, with additional levels billed with add-on Code +63048 unilateral or bilateral. In this procedure, the physician removes the spinous process. If the stenosis is central, the lamina may be removed out to the articular facets using a burr.
What is procedure code 22840?
The official CPT definition for code 22840 is “Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across one interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation).”
What is procedure code 22614?
CPT® Code 22614 in section: Arthrodesis, posterior or posterolateral technique, single level.
What is procedure code 22558?
CPT® Code 22558 in section: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression)
What is procedure code 22842?
CPT® Code 22842 in section: Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires)
What is the code for cervical below C2?
Codes 63075 and 22554 are still valid for use in cases where only those individual procedures are performed and they are not combined. Code 22554 is for an arthrodesis, anterior interbody technique, including minimal diskectomy to prepare interspace (other than for decompression); cervical below C2 performed without a discectomy procedure.
Where is the anterior cervical fusion incision?
In anterior cervical fusion procedures, the procedure is performed through an incision on the front of the neck just to the side, to avoid the trachea, esophagus and thyroid gland. There was a major change to the ACDF procedure for 2011. When anterior cervical fusions are performed, usually a discectomy is also performed.
What approach is used for cervical fusion?
There are many companion codes to these procedures, as detailed below. Cervical fusions are usually performed with an anterior approach and lumbar fusions are usually performed using a posterior approach.
How many times can a discectomy be coded?
When discectomy is performed on multiple levels (cervical, thoracic, lumbar, sacral, cervicothoracic, thoracolumbar or lumbosacral) each intervertebral disc would be coded, but only once per level (i.e., cervical, thoracic, lumbar, etc.) An example would be a patient that has L3-S1 partial discectomies.
What is discectomy surgery?
A discectomy is surgical removal of any herniated or damaged disc in the patient’s spine. When a disc is herniated (slipped, ruptured, bulging or prolapsed disc), the spinal nerves may become irritated and “pinched.”. The discectomy does not provide relief with the actual back/neck pain, but does typically relieve the associated radiating pain ...
What is discectomy in medical terms?
A discectomy can be either an excision (partial/removal of part of the disc) or a resection (total/removal of the entire disc). The operative report should describe if part or all of the disc material is removed.
Can a spinal fusion disc be filled with bone?
Most often, just the fragment of the disc that is irritating the nerve is removed leaving the remaining disc intact. If the entire disc is removed, the disc space may need to be filled with synthetic bone substitute or from the patient’s own bone ( see Parts 5&6 of this series). Discectomy is almost always performed during spinal fusion surgery.
Does discectomy help with back pain?
The discectomy does not provide relief with the actual back/neck pain, but does typically relieve the associated radiating pain (radiculopathy) from the pressure/irritation on the spinal nerve.
What is decompression of the spine?
Decompression is the general term to describe removal of the spinal disk, bone, or tissue causing pressure and pain. Often, this is the only procedure performed. Examples include: laminectomy to decompress spinal canal and/or nerve roots (e.g., 63001-63017, 63045-+63048), discectomy to decompress spinal canal and/or nerve roots (e.g., 63020-+63035, 63040-+63044, 63055-+63057), corpectomy (e.g., 63081-+63091), fracture repair (e.g., 22325-+22328), etc.#N#CPT® designates the decompression codes as being per “vertebral segment” or per “interspace.” Decompression occurs at the interspace for discectomy codes (e.g., right L4-L5 interspace). Discectomy is a single, standalone code, such as 63030 Laminotomy (hemilaminectomy), with decompression of nerve root (s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar.#N#But decompression of the spinal canal can be coded per vertebral segment (63001-63017), or per level of foraminotomy (e.g., decompression of the L4 exiting nerve root via partial laminectomy at L4 and partial laminectomy at L5, with foraminotomy at L4-L5, is reported using one code: 63047 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root [s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar).#N#Discern whether the approach was posterior or anterior to choose the correct code. Table A illustrates commonly used, standalone decompression codes for spine surgery.#N#Table A: Standalone decompression codes for spine surgery
Is spine coding difficult?
“It seems like coding spine cases is as complicated as doing the surgery,” said a spine surgeon at his first coding training session with me.#N#Spine procedure coding can make even the most confident coder squirm. But spine procedure coding doesn’t have to be difficult. In fact, it’s quite formulaic. Follow these five principles and spine procedure coding will go from scary to simple.
Do you need a bone graft code for fusion?
Because a fusion was performed, you must include a bone graft code. As with other graft codes in CPT®, the spinal bone graft codes are reported for harvesting the bone graft. The work of placing the bone graft is included in the arthrodesis/fusion codes. All spinal bone graft codes are add-on codes.
What is CPT code?
When physicians bill for services being performed, they use Current Procedural Terminology (CPT®) codes. Each CPT code has an assigned number of relative value units (RVUs) that attempt to compare the physician work, malpractice costs, and practice expenses associated with a given procedure or service to those associated with all other procedures or services . Medicare annually revises a dollar conversion factor that, when multiplied by CPT code RVUs, results in the national Medicare reimbursement for that code.
What is PCM disc?
The PCM Cervical Disc is a two-piece articulating device comprised of two cobalt chromium molybdenum (CoCrMo) alloy metal endplates, one cephalad and one caudal, and an ultra-high molecular weight polyethylene (UHMWPE) spacer fixed to the caudal endplate. It is indicated for use in skeletally mature patients for reconstruction of a degenerated cervical disc at one level from C3-C4 to C6-C7 following single-level discectomy for intractable radiculopathy (arm pain and/or a neurological deficit), with or without neck pain, or myelopathy due to a single-level abnormality localized to the disc space and manifested by at least one of the following conditions confirmed by radiographic imaging (CT, MRI, x-rays): herniated nucleus pulposus, spondylosis (defined by the presence of osteophytes), and/or visible loss of disc height as compared to adjacent levels. The PCM Cervical Disc is implanted using an anterior approach. Patients should have failed at least six weeks of conservative treatment prior to implantation of the PCM Cervical Disc.
Is cervical artificial disc replacement necessary?
Cervical artificial disc replacement is proven and medically necessary for treatment of persons with symptoms of degenerative disc disease at one level even if they have radiological evidence of degenerative disc disease at multiple levels . Radiologic evidence of degenerative disc disease is common in persons who are middle aged and older and does not necessarily correlate with clinical symptoms. Cervical artificial total disc replacement is proven and medically necessary for the treatment of symptomatic contiguous two level degenerative disc disease in skeletally mature patients when used according to U.S. Food and Drug Administration (FDA) labeled indications. (Note: not all cervical artificial discs have FDA labeling for contiguous two level degenerative disc disease. Only cervical artificial discs FDA labeled for contiguous two level disease are proven and medically necessary for this indication.) Cervical artificial disc replacement at one level combined with cervical spinal fusion surgery at another level (adjacent or non-adjacent) performed at the same surgical setting is unproven and not medically necessary. This is commonly referred to as a hybrid surgery. There is insufficient published clinical evidence in peer-reviewed medical literature demonstrating the safety and efficacy of combination cervical spine surgery at multiple adjacent or non-adjacent levels.
Do you need a letter of medical necessity for cervical disc arthroplasty?
It is not always necessary to submit a Letter of Medical Necessity (LOMN). However, a letter from the treating physician may help to ensure approval for cervical disc arthroplasty using the PCM® device. The LOMN should contain the following elements:
What is the code for bone grafts?
To report bone graft procedures, see 20930-20938. (Report bone graft procedures, see 20930-20938. (Report in addition to code[s] for definitive procedure[s].) Do not append modifier 62 to bone graft codes 20900-20938.
What is a vertebral segment?
A vertebral segment describes the basic constituent part into which the spine may be divided. It represents a single complete vertebral bone with its associated articular processes and laminae.
