CPT code 22632 is for arthrodesis, a surgical procedure to fuse two bones in the spine, for each additional interspace.
CPT code 22632 is used for the surgical procedure of arthrodesis, which involves the fusion of a joint. Specifically, this code refers to the fusion of each additional interspace or segment in the lumbar spine, beyond the first one. This means that if a surgeon is performing a spinal fusion on multiple segments of the lumbar spine, CPT code 22632 would be used to indicate each additional segment fused after the initial one.
For CPT code 22632, which pertains to arthrodesis, posterior technique, single interspace, lumbar, each additional interspace, the following modifiers may be applicable:
1. Modifier 22 (Increased Procedural Services): This modifier is used when the work required to perform the procedure is substantially greater than typically required. For example, if there are complications or additional work involved in the arthrodesis procedure.
2. Modifier 50 (Bilateral Procedure): If the procedure is performed bilaterally, this modifier should be appended to indicate that the procedure was performed on both sides of the body.
3. Modifier 51 (Multiple Procedures): This modifier is used when multiple procedures are performed during the same surgical session. It indicates that the arthrodesis was one of several procedures performed.
4. Modifier 59 (Distinct Procedural Service): This modifier is used to indicate that the procedure is distinct or independent from other services performed on the same day. It is particularly useful when the arthrodesis is performed in conjunction with other procedures that are not typically reported together.
5. Modifier 62 (Two Surgeons): If two surgeons are required to perform the procedure due to its complexity, this modifier should be used to indicate that both surgeons are sharing the responsibility for the procedure.
6. Modifier 76 (Repeat Procedure by Same Physician): This modifier is used if the same physician needs to repeat the arthrodesis procedure on the same day.
7. Modifier 77 (Repeat Procedure by Another Physician): This modifier is used if a different physician needs to repeat the arthrodesis procedure on the same day.
8. 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.
9. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used if an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
10. Modifier 80 (Assistant Surgeon): This modifier is used when an assistant surgeon is required to help perform the procedure.
11. Modifier 81 (Minimum Assistant Surgeon): This modifier is used when a minimum assistant surgeon is required for the procedure.
12. Modifier 82 (Assistant Surgeon (when qualified resident surgeon not available)): This modifier is used when an assistant surgeon is required because a qualified resident surgeon is not available.
13. 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 for CPT code 22632, which refers to "Arthrodesis, posterior technique, single interspace; lumbar, each additional interspace." 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 22632 is approximately $1,000. However, it is crucial 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.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 22632 for arthrodesis procedures. Ensure you're receiving the full reimbursement you're entitled to from each payer. Schedule a demo today to see how RevFind can optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
