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The Field Guide to Physician Coding 2nd Edition

Forum Discussion Areas > Ask Us a Question > 63081, 22551, 22552

63081, 22551, 22552

DebraS

63081, 22551, 22552

Posted:
Mar 8 2011, 5:48 AM

My physician billed out the above 3 procedures. 63081 and 22552 paid however the 22551 denied as not paid separately. I guess I'm looking for a better explanation of these new codes and how to code if he does a corpectomy as well?

MLegrand

Corpectomy with Anterior Cervical Interbody Fusion

Posted:
Mar 8 2011, 7:54 AM

Medicare has a CCI edit in place between 63081 and 22551. Review your claim submission to ensure the services were separately reportable.

BMoe

63081,22551,22552

Posted:
Mar 8 2011, 8:39 AM

Since a corpectomy includes the discectomies above and below the corpectomy, you shouldn't use 22551 (which is both the discectomy and the fusion). You should use 63081 and 22554 for the fusion only. I attended a webinar by Dr Przybylski with the AANS and that's how it was explained. Bonnie Moeller Coding and Charge Entry Ft Wayne Neurosurgery/Physical Medicine/NeuroSpine&Pain Surgery Center

KPollock

63081, 22551, 22552

Posted:
Mar 8 2011, 10:22 AM

CPT® 63081 includes the diskectomy (63075, 63076) at the interspaces above and below the level of the corpectomy assuming a total corpectomy was performed. However, 63081 does not include the fusion (22554 and 22585 for the second level). Contrast that to 22551 which includes both the diskectomy (63075) and the fusion (22554) at the same level.

Therefore, when you do a total corpectomy and fusion at the same level you would bill 63081 with 22554 and 22585. CPT® 22551/22552 should not be billed for the same corpectomy level.

Kim Pollock, RN, MBA, CPC KarenZupko & Associates, Inc. www.karenzupko.com

DebraS

22551, 22845

Posted:
Mar 24 2011, 5:47 AM

Thanks, that was very helpful. I forgot to mention, since I've figured out a little more, they are paying the 63081 and 22552 and 22845 but not the 22551. My doc knows he cannot do 2 procedures on the same level and I read where 22845 and 22551 cannot be billed together either? Medicare and United are denying 22551. They are paying the add'l level 22552 which I guess makes sense since they paid the 63081 as well, but the 22845 and 22551 not together I need to understand a little better. Sorry, but I get more explanation here than anywhere else I've gone. We have a coder in our corporate office, but getting her to respond is like pulling teeth. Thanks

blsrdwdm

re: 22551, 22845

Posted:
Mar 29 2012, 9:30 PM

change 22551 to 22554 and you will get paid.

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