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Coding tip: Know what the "global package" includes and excludes for spinal procedures

Ambulatory Surgery Reimbursement Update, August 7, 2007

The following items are not billable:

• SSEP monitoring (CPT code 95920)
• Placement of cranial tongs (CPT 20660)
• Harvest of graft material through the same incision to repair an intra-operative dural tear, an approach to the anterior lumbar spine (CPT code 49010)
• Use of microdissection (CPT 69990) in the anterior cervical discectomy procedure

Items that are billable include the following:

• Stereotactic navigation (CPT code 61795) when the surgeon plans its use in the procedure prior to the incision
• Bone marrow aspirate from the iliac crest (CPT code 38220)
• Exploration of a fusion (CPT 22830) performed at a different level from the fusion being performed
• Harvest of local bone (CPT code 20936) from the same incision to complete an arthrodesis and microdissection (CPT code 69990) performed with Laminectomy or Decompression procedures; however, note that this is not reimbursed by Medicare

This tip is brought to you by Ellis Medical Consulting, Inc.

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