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O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U LY 2 0 1 5
A Partial and Confusing List of Spine Codes
Your claims could include excluded and covered services.
F
or surgery centers, billing spinal surgery can be as complicat-
ed as performing a lumbar spine fusion. That's because CMS
failed to include some of the codes for spinal procedures
commonly performed together with the codes it added in its ASC 2015
payment rule. Here's what you need to know about listing excluded
services on a claim with covered services.
CMS adds 9 spine codes
In its ASC 2015 payment rule, CMS finalized the addition of the fol-
lowing 9 spine codes as separately payable, effective Jan. 1, 2015:
22551 (Neck spine fuse&remov bel c2)
22554 (Neck spine fusion)
22612 (Lumbar spine fusion)
63020 (Neck spine disk surgery)
63030 (Low back disk surgery)
63042 (Laminotomy single lumbar)
63045 (Removal of spinal lamina)
63047 (Removal of spinal lamina)
63056 (Decompress spinal cord)
CMS also added 2 other codes to the ASC payable list: 22614 (Spine
fusion extra segment) and 63044 (Laminotomy, additional lumbar).
These codes, however, are not separately payable since they have
been packaged with other codes on the list.
Additionally, CMS agreed with the Ambulatory Surgery Center
Association's assessment that CPT codes 22551, 22554 and 22612 were
assigned to the wrong ambulatory payment classification (APC) group
C O D I N G & B I L L I N G
Kara Newbury, JD
