Cervical Fusion with Disc Removal - JF Part B
Medical Review
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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
- Information in this section will be available later
Codes
| Code | Description |
|---|---|
| 22551 | Fusion of spine bones with removal of disc at upper spinal column, anterior approach, complex, initial |
| 22552 | Fusion of spine bones with removal of disc in upper spinal column below second vertebra of neck, anterior approach, each additional space (add-on) |
The Prior Authorization for Certain Hospital Outpatient Department Part B Associated Codes List is in Appendix B of the CMS OPD Operational Guide.
Resources
- Prior Authorization for Certain Hospital Outpatient Department (OPD) Services (CMS)
Federal Register
Last Updated Thu, 27 Oct 2022 15:24:22 +0000