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Surgery Center Coding Guidance: PLIF and TLIF Procedures

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The following article is written by Stephanie Ellis, RN, CPC, president of Ellis Medical Consulting.

 

Posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) procedures are coded 22630 for a lumbar initial interspace arthrodesis, posterior interbody technique, which includes a laminectomy and/or discectomy to prepare interspace (other than for decompression). Use add-on code 22632 for each additional lumbar interspace arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression).

 

In these procedures, the surgeon removes the entire facet joint so that more disc material can be excised during the procedure to decrease nerve retraction. These procedures are only performed on one side of the spine — not bilaterally, which would result in spinal instability. An example of coding for the PLIF procedure performed at two levels — L3-4 and L4-5 using cages and a morcellized autograft harvested from the iliac crest — would be:

 

22612

22630

63047-59

22842

22851

22851-59

22614

22632

63048

20937

38220-59

76000-59-TC

L8699


Learn more about Ellis Medical Consulting.

 

The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.

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