November 2007 page 8a
Coding Communication:Surgery: Musculoskeletal System
Question: What is the appropriate code to report if anterior
instrumentation is inserted at vertebral segments C3-4 and
additional instrumentation is inserted at C6-7, but vertebral
segments C4-5 and C5-6 are not fused? Are the anterior
instrumentation codes assigned strictly by the TOTAL number
of spinal segments with instrumentation applied (ie, 22846) or
is the appropriate code chosen based on the vertebral segments
involved in each separate construct (ie, 22845, 22845 59)?
Answer: Anterior instrumentation codes 22845-22847 may
be reported separately with modifier 59, Distinct procedural
service, appended when the procedure...
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