Arthrodesis Codes for Reporting Both Thoracic and Lumbar

Question:

Our neurosurgeon performed arthrodesis on a patient from T11 – L3 and we coded as 22612, 22610 and 22614 x2 and 22610 is being denied; can we add modifier 59?

Answer:

No; CPT codes 22610 and 22612 are both primary codes, and should not be reported together, if performed at the same operative session.  Correct reporting of an arthodesis that crosses a spinal junction, is reported  with one primary code and all other interspaces reported with the additional interspace code +22614.   

Select a primary code where most of the work is performed, in this case, lumbar.  So report 22612 as the sole primary code and 22614 x 3 for the additional interspaces. 

*This response is based on the best information available as of 6/20/24.