Placement of Pedicle Screws/Rods Only

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Question:

What code to use for placing pedicle screws only? No other procedure performed so there is no primary procedure to use. Patient has a failed fusion and soon after (during the global period) the neurosurgeon surgeon said she reinforced the fusion by placing pedicle screws/rods only…nothing more. I’ve heard you say, at AANS courses, to use an unlisted code for this (22899). I did that but the payor denied both 22899 saying it was an “appropriate parent” code for 22840. Now what?

Answer:

Actually, I think there is some confusion. When we recommend using 22899 that means you report only 22899. It is not accurate to report both 22899 and 22840. The unlisted code, 22899, would represent your entire procedure.