AMA CPT® Assistant - 2011 Issue 12 (December)

Surgery: Musculoskeletal System (Q&A) (December 2011)

December 2011 page 14a Surgery: Musculoskeletal System Question 1: If a physician performs posterior interbody fusion at L4-L5 (eg, code 22630) and also places a bone graft in the lateral gutters of L4-L5 for lateral fusion (eg, code 22612), can both procedures be billed separately for the extra work involved, or is the lateral fusion inclusive of the interbody fusion? Jennifer White, CPC Answer 1: From a CPT coding perspective, posterolateral fusion and posterior interbody fusion are two distinct procedures. Unlike the posterolateral intertransverse fusion, the posterior lumbar interbody fusion (PLIF) achieves spinal fusion in the low back by...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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