Forum - Questions & Answers

May 11th, 2015 - LBAROGIANIS 250 

Need help -neurosurgery coding

Patient had an open reduction and posterior instrumentation, bilateral C5 through C7 with lateral mass screw and rod construct and bilateral posterior arthrodesis at C5-C7.

We coded 22326, 22328, 22600-51, 22614, 22842 and 20937.

UHC split our claim and only paid for 22326, 22328 and 20937. They are saying the other codes are not document. However, they are documented and according to AMA CCI edits all the codes can be billed together with no modifier.

Can any one tell me if 22326 is already included in 22600? thanks for your help?

May 11th, 2015 - petunia 195 


Those codes do not appear to be bundled per CCI. If they are stating the codes are not documentated you may need to send them notes with guidance. I would normally underline the portions of the notes that are important and maybe even indicate the CPT® code for their understanding. It helps sometimes.

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