Month: January 2017


Replacement Code for “Interbody Cage for Disc”

I see that CPT code 22851 - Application of intervertebral biomechanical device(s) to vertebral defect or interspace was deleted in 2017. What code do I use in 2017 for placement of an interbody cage for disc that does not have integral fixation and is being used for fusion? I see the new codes 22853 and 22854 both say with integral anterior instrumentation device for anchoring.


E/M Guidelines: How Many Elements Make a Comprehensive Exam?

I have a question after a recent coding/billing seminar with Teri Romano (which was excellent!). I use the 1997 Physical Exam Rules and am trying to figure out the required elements for a comprehensive exam. Most information says you need 2 bullets from each of 9 organ systems. While this is easy to understand, I noticed the guidelines also says:


Cosmetic Closure After Spine Surgery

My friend the spine surgeon asked for my help on an upcoming case. It is a two-level anterior cervical discectomy and fusion where the patient requested a plastic surgeon to make the incision and do a cosmetic closure. I checked with his billing office and the codes for the case are 22551, +22552, +22845, and +20931. Am I a co-surgeon (modifier 62) on all the same codes because I’m doing the incision and closure?


An Office Visit and an Injection. Can I Bill Both with a Modifier 25?

A colleague informed me that billing an office visit every time I give a patient an injection can lead to an audit. I also read a recent article where an orthopedic practice had to pay back millions of dollars partially for this reason. I typically bill an established patient visit with an injection, but I always add a 25 modifier to the visit. Does that mean I am safe from an audit?

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