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in the proposed rule and
moved these codes to APC
0425, which has a higher
reimbursement than the
group to which they were
originally assigned.
But because spine cases
often have multiple codes
associated with one case,
the new additions have
made billing for these proce-
dures tricky. The 2015 rule
left many wondering how to
submit claims to Medicare
for their spine cases since
only some of the procedures
commonly performed
together have made the list.
Billing for complicated spinal cases
The inclusion of some, but not all, of the spinal codes is problematic.
Take, for example, a spine surgeon who performs a medically neces-
sary anterior cervical discectomy and fusion surgery (CPT 22551 and
22552), with morselized allograft (CPT 20930), application of interver-
tebral biomechanical device (CPT 22851) and anterior instrumenta-
tion of 2 to 3 vertebral segments (CPT 22845) in an ASC.
We know that 22552, 20930 and 22851 are routine components of the
main code, 22551, and that most surgeons often use the anterior plate
with or without the cage when performing the core procedure. Cases
z TRICKY BILLING CMS's addition of some spinal codes without
other commonly-related ones creates billing confusion for ASCs.
