Cervical Fusion with Disc Removal

General Documentation Requirements for Cervical Fusion with Disc Removal and related services:

  • Condition requiring procedure
  • Physical examination
  • Duration/character/location/radiation of pain
  • Activities of Daily Living (ADL) limitations
  • Pertinent imaging reports
  • Operative report(s) (when available)
  • Conservative treatment modalities
    • Physical therapy (PT)
    • Occupational therapy (OT)
    • Injections
    • Medications
    • Assistive device use
    • Activity modification

Coverage Criteria

Codes

Code Description
22551 Arthrodesis, anterior interbody, including disc space preparation, disectomy, osteophytectomy, and decompression of spinal cord and/or nerve roots; cervical below C2
22552 Arthrodesis, anterior interbody, including disc space preparation, disectomy, osteophytectomy, and decompression of spinal cord and/or nerve roots; cervical below C2, each additional space

 

The Prior Authorization for Certain Hospital Outpatient Department Part B Associated Codes List is in Appendix B of the CMS OPD Operational Guide.

Resources

 

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