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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.

 
hotelito
re: 63081, 22551, 22552
Posted:
Apr 17 2014, 3:12 AM
In 2009, we performed the following: 1) C4-6 (22554), C5-6 (22585) ACFD + C5 Corpectomy (63081) 2) Anterior Cervical Plate (22845) 3) Bone Morhogenetic protein (20936) 4) PEEK Corpectomy Cage (22851)

The insurance company denied 20936, stating denied "investigational" use of BMP should have billed under allograft with BMP notation. Now they are demanding reimbursement for the entire procedure. How should we have indicated use of BMP in 2009?

Thank you

 

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