Bilateral Spinal Instrumentation

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November 13, 2014

Question:

Can I bill the posterior instrumentation codes such as 22840 and 22842 with modifier 50 because I do put pedicle screws and rods on both sides of the spine?

Answer:

Good try, but no. The spine is considered a central structure for purposes of the instrumentation codes, so it is not appropriate to append modifier 50 to the posterior instrumentation codes. It also is not accurate to append modifier 50 to the anterior instrumentation codes (e.g., 22845) or the intervertebral device code (22851).