Exposure for Spine Surgery – How Many Levels Can the Co-Surgeon Report?


October 2, 2014


I asked my colleague, a vascular surgeon, to provide anterior exposure for an anterior lumbar interbody fusion. At times, this exposure allows for a spine procedure at more than one level. Do we add modifier 62 to all ALIF codes (the first level, 22558, and each additional level, 22585) or just the first level (22558)?


Modifier 62 may be appropriately appended to add-on codes (22585) as well as the parent code (22558). If the approach surgeon’s exposure is more extensive to accommodate more than the first level anterior lumbar interbody fusion (22558), then s/he may also report the additional levels with modifier 62. Example: a 2 level procedure would be reported as 22558-62 and 22585-62 for the additional level. Remember, the instrumentation codes (e.g., 22845, 22851) and the bone graft codes (e.g., 20930-20938) may not be appended with modifier 62 according to CPT rules. If the approach surgeon stays for the remainder of the procedure to assist, then the approach surgeon can bill the additional codes with an assistant surgeon modifier such as 80 or 82.

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