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LAST UPDATED: 25 Oct, 2022
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3 2021 CMS OPPS/ASC Final Rule, Addendum AA (available on CMS website), CMS 1736-FC (Dec. 3, 2020). Commonly Billed Codes 2021 Diagnosis Coding ICD-10-CM Description M51.06 Intervertebral disc disorders with myelopathy, lumbar region M51.16 Intervertebral disc disorders with radiculopathy, lumbar region
https://www.barricaid.com/wp-content/uploads/2020/12/MLT38-Rev.-A-Commonly-Billed-Codes-2021.pdfCPT Code Primary Surgery Allowable Billed Groupings Additional Covered Lumbar Decompression 63047 63005, 63012, 63017, 63042, +63044, 63047, +63048, 63056, +63057 HMSA Spine Surgery Utilization Review Matrix 2021 03.01.21_FINAL Page 2 of 3 CERVICAL SPINE SURGERY Primary Surgery Request Primary CPT Code
https://www1.radmd.com/media/927812/hmsa-spine-surgery-utilization-review-matrix-2021-030121_final.pdfunilateral or bilateral; lumbar $4,020.32* *Addendum AA-Final ASC Covered Surgical Procedures for CY 2022. Released 11/ 2021 . CPT Code Description HOSPITAL 2022 Medicare Rate (National Average-Subject to Wage Indexing) Ø275T (APC 5114) Status Indicator (J1)* Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of
https://www.vertosmed.com/wp-content/uploads/2021/12/2022-BillingGuide_D7.pdfCPT Code Lumbar Decompression Procedures 63042 Laminotomy, (hemilaminectomy) with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar +63044 Laminotomy, (hemilaminectomy) with decompression of nerve root(s),
Cervical and Lumbar Spinal Procedures MPM 25.1 CPT Code Lumbar Decompression Procedures 63017 Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy, more than 2 vertebral segments; lumbar 63030 Laminotomy, with decompression of nerve root(s), including partial
CPT Code Lumbar Spinal Fusion (single level) Surgery 22633 Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace, single interspace and segment; lumbar For CPT codes listed above include also Decompression (see below for codes)
Proper coding is: Combined decompression/fusion: 22551 for the first level and +22552 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; each additional interspace (List separately in addition to code for separate procedure) for the additional level
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