April 3, 2014
I ask my colleague, the general surgeon, to do the retroperitoneal exposure for my anterior lumbar interbody fusions (ALIF). I always thought the approach was included in the ALIF code but my general surgeon tells me he’s been billing 49010 for the exploratory laparotomy, retroperitoneal. Now I’m worried that I am losing out.
You are correct – the anterior lumbar interbody fusion code (22558) does indeed include the approach, the definitive service (e.g., discectomy, preparation of endplates, fusion), and the closure. Therefore, it is appropriate for both you and the general surgeon to report 22558 appended with modifier 62 (two surgeons/co-surgery). Reporting 49010 separately is essentially “double dipping” on the approach.