Our doctor performed a removal of Cervical plate and exploration of the prior fusion at C5-6, and a new ACDF at C4-5 and C6-7 with an anterior cervical plate extending from C4 down to C7 due to C4-5 and C6-7 stenosis spinal cord compression. We billed the surgery out to Regence Blue Shield of Id as : 22551,22552,22830-51,59 , 22845,20931. All codes were allowed except for the 22830 so we sent in appeal stating that the 22830 was performed on level C5-6 due to a upper motor neuron injury , and the new fusion codes were performed at levels C4-5 and C6-7 .

Regence sent us another denial and have asked us to appeal to an outside company along with paying a $ 50.00 filing fee. Has anyone else had issues with this type of coding and I am now wondering if a removal code would have been better than an exploration code.

Any help is appreciated, thank you so much,

Stephanie