NEUROSURGERY: Don't Bill 22855 And 22845 Unless You Can Prove They're Separate

Why This Topic Matters

Claims for these neurosurgical procedures may be denied or challenged by payers, so understanding the article helps practices evaluate coverage risk, documentation needs, and how the topic is discussed in relation to billing workflows.

Article Sections

1. Put a stop to x-stop denials with communication

   Introduces payer denial concerns involving a lumbar interspinous device and outlines the broader coverage discussion around communication with carriers and supporting documentation.

2. Coding

   Addresses the coding discussion associated with the device procedure, including the article’s mention of alternative coding approaches and carrier preferences.

3. Not-so-successful story

   Discusses the billing controversy involving two spinal procedure codes, denial patterns reported by practices, and the role of payer review.

4. Alternative

   Summarizes the article’s alternative scenario involving hardware removal and reinsertion in spinal surgery and the associated payer considerations.

5. Bottom line

   Closes with a high-level summary of the circumstances the article discusses for distinguishing separate spinal hardware procedures.