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This one is a Spinal Fusion CPC Practice Exam Question.
Q: The surgeon performed anterior fusion from L1 to L3. What CPT code(s) are reported?
A: A) 22630, 22632. And I have the codes down here. The difference between the 558 and the 585 is the approach; it’s the anterior interbody technique. The difference between 630 and 632 is that they’re the posterior interbody technique.
This one said the surgeon performed anterior – so right off the bat, process of elimination, we’re going to throw out codes 22630 or 22632 because we’re dealing with an anterior fusion.
When I’m teaching questions from the nervous system or anything having to do with the spine, I’ll tell you: stack your bones. Write them on the answer grid, on your documentation that you’re coding from and put them on top of each other, just like they would show on the real spine.
So, it said L1 through L3 – so that would mean you would write L1, L2 underneath that, L3 underneath that. So now you can quickly visualize you’ve got 3 segments you’re dealing with and 2 interspaces. The space between these is sometimes what the unit of measure is that we’re looking for, versus the actual segments.
CPC Exam Spinal Fusion Practice Exam Medical Coding – Video
This was an arthrodesis, which is a fusion and therefore we’re talking about interspaces. It goes on to say in the CPT Index look up Arthrodesis, Vertebra, Lumbar/ Anterior/ Anterolateral Approach which points to 22558. There are interspaces between L1 – L2 and L2 – L3, so we need to code for one additional interspace (not 2) using the add-on code 22585. That’s how you would break down that question.
This is what the codes look like in the manual versus taken from Super Coder. 22554 anterior interbody technique, and then your 22630 is posterior. By looking at your manual, if you have bubbled and highlighted that’s the technique that we teach in the Blitz, then that is very visual cue to the difference. When you go back and you look at your [blip], you now know what you’re abstracting for, because the way we teach is you look at the answers first and then go read the [blip] to see what you’re looking for.
So, by looking at the answers first, you’d see, “OK, I have this batch here that’s for anterior and I have this batch of codes that’s for posterior, what am I dealing with?” And we decided it was anterior, so now we can get rid of all the codes on the right-hand side of the page and just deal with these.
Then, we needed to figure out, we have a lumbar, 22558, so that’s your first lumbar then it says “each additional interspace.” And because we stacked the bones, we could clearly see we only had two interspaces, so that’s 22585; which makes the answer “D” again.