Coding Examples

LUMBARAnterior Lumbar Interbody Fusion (ALIF) with Posterior InstrumentationProcedure Description CPT® CommentsAnterior Interbody Fusion, Lumbar 22558

22585 each additional interspaceApplication of Biomechanical Device (cages, etc.) 22851

22851 59 each additional interspacePosterior Instrumentation 22840

228422284322844

non-segmental instrumentationsegmental; 3 – 6 vertebral segmentssegmental; 7 – 12 vertebral segmentssegmental; 13+ vertebral segments

Use of bone graft:Allograft (morselized)Allograft (structural)Autograft (rib/lamina/spinous process, same incision)Autograft (morselized, separate incision)Autograft (structural, separate incision)

2093020931209362093720938

Add-on codeAdd-on codeAdd-on codeAdd-on codeAdd-on code

ALIF with Anterior InstrumentationProcedure Description CPT® CommentsAnterior Interbody Fusion, Lumbar 22558


22851 59 each additional interspaceAnterior Instrumentation 22845

2284622847

2 – 3 vertebral segments4 – 7 vertebral segments8 or more vertebral segments


2093020931209362093720938


ALIF with INFUSE® Bone Graft and LT-CAGE® Lumbar Tapered Fusion Device, Single LevelProcedure Description CPT® CommentsAnterior Interbody Fusion, Lumbar 22558

Application of Biomechanical Device (cages, etc.)Placement of osteopromotive material

2285120930 Add-on code

Note:code 20930 should be reported for rhBMP ( INFUSE® Bone graft).

This list represents coding examples for common spine procedures. The information can also be used in conjunction with the Medicare Fee Calculator on www.medtronicsofamordanek.com/spineline to estimate the amount of physician reimbursement expected from the performance of one or more of these procedures.

LUMBAR (continued)ALIF and Posterolateral Fusion (Classic 360° Procedure)Procedure Description CPT® CommentsPosterolateral Fusion, Lumbar 22612

22614 each additional segmentAnterior Interbody Fusion, Lumbar 22558

2258551

each additional interspacePosterior Instrumentation 22840

228422284322844


Application of Biomechanical Device (cages, etc.) 2285122851 59 each additional interspace


2093020931209362093720938


Posterior Lumbar Interbody Fusion (PLIF) or Transforaminal Lumbar Interbody Fusion (TLIF) with Posterior InstrumentationProcedure Description CPT® CommentsPosterior Interbody Fusion, Lumbar 22630



228422284322844



2093020931209362093720938


Note: Codes 63030 and 63047 are bundled per the NCCI edits with code 22630. CPT® Assistant (January 2001, page 12) states that

code in this instance).

Laminectomy, LumbarProcedure Description CPT® CommentsLaminectomy without Facetectomy, Foraminotomy or Discectomy, Lumbar, except for spondylolisthesis

6300563017

one or two vertebral segmentsmore than 2 vertebral segments

Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression, for spondylolisthesis, lumbar

63012 Gill-type procedure

Laminotomy (hemilaminectomy), including partial facetectomy, foraminotomy and/or excision of herniated disc, lumbar

6303063035

one interspaceeach additional interspace

Laminotomy (hemilaminectomy), including partial facetectomy, foraminotomy and/or excision of herniated disc, re-exploration, lumbar

6304263044

one interspaceeach additional interspace

Laminectomy, facetectomy and foraminotomy, lumbar 6304763048

single vertebral segmenteach additional segment

LUMBAR (continued)PLIF/TLIF and Posterolateral Fusion (Single Incision 360°)Procedure Description CPT® CommentsPosterolateral Fusion, Lumbar 22612

22614 each additional segmentPosterior Interbody Fusion, Lumbar 22630

2263251

each additional interspacePosterior Instrumentation 22840

228422284322844


Application of Biomechanical Device (cages, etc) 2285122851 59 each additional interspace


2093020931209362093720938


Note: Codes 63030 and 63047 are bundled per the NCCI edits with code 22630. CPT® Assistant (January 2001, page 12) states that these codes

PLIF with Posterior Instrumentation, via METRx® System/CD HORIZON® SEXTANT® SystemProcedure Description CPT® CommentsPosterior Interbody Fusion, Lumbar 22630



22842non-segmental instrumentationsegmental; 3 – 6 vertebral segments


2093020931209362093720938


Note: Codes 63030 and 63047 are bundled per the NCCI edits with code 22630. CPT® Assistant (January 2001, page 12) states that these codes

Direct Lateral Fusion with Anterior Instrumentation (DLIF)Procedure Description CPT® CommentsAnterior Interbody Fusion, Lumbar 22558


22851 59 each additional interspaceAnterior Instrumentation 22845

2284622847

2 – 3 vertebral segments4 – 7 vertebral segments8 or more vertebral segments


2093020931209362093720938


LUMBAR (continued)Posterolateral Fusion with Posterior InstrumentationProcedure Description CPT® CommentsPosterolateral Fusion, Lumbar 22612

22614 each additional segmentPosterior Instrumentation 22840

228422284322844



2093020931209362093720938


Discectomy, LumbarProcedure Description CPT® CommentsPosterior Discectomy, Lumbar 63030

63035 each additional interspace

Note:

Allograft (morselized)Allograft (structural)Autograft (rib/lamina/spinous process, same incision)Autograft (morselized, separate incision)Autograft (structural, separate incision)

2093020931209362093720938


Discectomy, LumbarProcedure Description CPT® CommentsPosterior Discectomy, Lumbar 63030


Note:

Balloon KyphoplastyProcedure Description CPT® CommentsPercutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, one vertebral body, unilateral or bilateral cannulation (e.g., kyphoplasty)

225232252422523

thoraciclumbareach additional level

Use of bone graft: X-STOP®

Procedure Description CPT® CommentsInsertion of posterior spinous process distraction device (including necessary removal of boneor ligament for insertion and imaging guidance), lumbar; single level

0171T0172T each additional level

Use of bone graft:

CERVICALAnterior Cervical Discectomy with Interbody Fusion (ACDF)

Procedure Description CPT® Comments

Anterior interbody fusion, with discectomy and decompression;cervical below C2


Anterior Instrumentation 228452284622847

2 – 3 vertebral segments4 – 7 vertebral segment8 or more vertebral segments

Use of bone graft:

Allograft (morselized)Allograft (structural)Autograft (rib/lamina/spinous process, same incision)Autograft (morselized, separate incision)Autograft (structural, separate incision)

2093020931209362093720938


Cervical ArthroplastyProcedure Description CPT® CommentsTotal Disc Arthroplasty, Anterior Approach, Cervical 22856

LaminoplastyProcedure Description CPT® CommentsLaminoplasty, Cervical With Reconstruction

6305063051

two or more vertebral segments

Note: Do not report 22554 or 22585 with 63075 or 63076 even if performed by di�erent physicians. To report anterior cervical discectomy and interbody fusion at the same level during the same session, use 22551.

The materials and information cited here are provided to assist in obtaining coverage and reimbursement for healthcare services. However, there can be no guarantee or assurances that it will not become outdated, without the notice of Medtronic, or that the government or other payors may not differ with the guidance contained here. The responsibility for coding correctly lies with the healthcare provider ultimately, and we urge you to consult with your coding advisors to resolve any billing questions that you may have. All products should be used according to their labeling.

CPT copyright 2009 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS restrictions apply to government use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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