Wiki 22630 vs 22633

solocoder

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Can someone explain the difference between 22630 and 22633 to me? I think it is the "OR" in the description of 22633 that confuses me. If we can use 22633 for posterior OR posterolateral, then I don't see any difference in the two descriptions. Sorry, not much experience in spine coding.

Thanks!
 
Read the full description of each again. Note the differences in wording,
22633 is combined posterior or posterolateral WITH interbody. You will see it stated sometimes as TLIF with posterior or posterolateral, or PLIF combined, or words like that. It is a combined fusion at the same level. Not just the interbody only.

This is old but explains the two. https://www.outsourcestrategies.com/blog/key-tips-to-avoid-obsolete-spinal-coding-practices/

Reference sheet: https://www.nuvasive.com/wp-content/uploads/2023/04/2023-NuVasive-reimbursement-guide.pdf

Medtronic usually has free spine coding webinars here: https://www.medtronic.com/en-us/hea...d=vanity_url_medtronic_com_spineline_RTG_FY20
 
22633 means they are doing both 22612 and 22630 at the same interspace/level. It is a combined code made to describe this procedure. 22630 is only the interbody alone.
It is the operative technique being done to accomplish the fusion.
You have to read the entire description and not leave out the word combined in 22633.
It might help you to watch some operative videos or basic spinal coding webinars or see some op notes (if you work at a spine group) to understand. Where I used to work it was rare that my docs did 22630. Most of them were 22633.

Prior to 2011 or 2012 (I forget which year) these were coded very differently and after that changes came along to CPT to code for the combined. We used to also be able to code two primary fusion CPT for the same case. Now you can only do one, main primary CPT and the rest of the CPT are add-ons for a multi-level. For example, 22633, 22634, 22614 may be seen on the same case. Sometimes they do not do an interbody at all levels of a multi-level fusion.
 
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