CPT code 22552 is for an additional anterior interbody arthrodesis of the cervical spine, performed during the same session as the primary procedure.
CPT code 22552 is for an additional arthrodesis procedure, which is a surgical fusion of the spine, specifically in the cervical (neck) region. This code is used when an additional level of the cervical spine is fused during the same surgical session as the primary procedure.
When billing for CPT code 22552 (Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2, each additional interspace (List separately in addition to code for primary procedure)), the following modifiers may be applicable:
1. Modifier 51 (Multiple Procedures): This modifier is used when multiple procedures are performed during the same surgical session. Since CPT code 22552 is an add-on code, it is typically billed alongside a primary procedure, and Modifier 51 may be applied to indicate that multiple procedures were performed.
2. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. Modifier 59 may be necessary if CPT code 22552 is performed in a different anatomical site or through a separate incision from other procedures.
3. Modifier 62 (Two Surgeons): If two surgeons are required to perform distinct parts of the procedure, Modifier 62 can be used to indicate that the work was shared between two surgeons.
4. Modifier 76 (Repeat Procedure by Same Physician): This modifier is used if the same physician needs to repeat the procedure on the same day. Modifier 76 would be applicable if CPT code 22552 is performed more than once on the same day by the same provider.
5. Modifier 77 (Repeat Procedure by Another Physician): If a different physician repeats the procedure on the same day, Modifier 77 should be used. This indicates that the procedure was repeated by another provider.
6. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period): This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period of the initial surgery.
7. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used if the procedure is performed during the postoperative period of another surgery but is unrelated to the initial procedure.
8. Modifier AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery): This modifier is used when a physician assistant, nurse practitioner, or clinical nurse specialist assists in the surgery.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for the services provided.
Medicare does reimburse CPT code 22552, which refers to "Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2, each additional interspace (List separately in addition to code for primary procedure)." The reimbursement amount can vary based on several factors, including geographic location and specific Medicare Administrative Contractor (MAC) policies. As of the latest available data, the national average reimbursement for CPT code 22552 is approximately $1,200. However, it is essential to verify the exact reimbursement rate with your local MAC or through the Medicare Physician Fee Schedule (MPFS) for the most accurate and up-to-date information.
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