XLIF, DLIF or what ever else the companies will call their new products are just that, new products for a new procedure. A lateral approach to the spine that does not require an access surgeon. If anything this is a modified or minimally invasive thorasic approach.
The procedure itself is performed either by an extracavitary lateral approach or anterior/ anterior lateral approach for spinal fusion. XLIF, DLIF, ALIF are acronyms for the procedures and if used as a marketing tool, you need to be sure that the procedure is classified correctly. Insurance carriers are reading the operative notes for the approach and access to the spinal column. We have been told to correct our codes to represent the approach dictated in the operative notes; ie; represent the extracavitary lateral procedure when in fact the op note states just that. The carriers have denied the anterior codes in these cases because they do not represent the procedure performed. They are not accepting the NASS guidelines as the general rule. We bill out the cases with the appropriate codes that correlate to the operative report, regardless of the manufacturer or the product name.
By dictation, either one will gain insurance approval with the ALIF code.
ReplyDeleteBut it is Anterolateral surgery.
Almost all ALIF's have an insertion postion for an Anterolateral approach. What's the difference?
ReplyDeletedirect lateral
ReplyDeleteAnterior Fusion and Anterior Instrumentation Procedure Codes. CPT codes 22554,22556,22558,22585,22845,22846,22847 apply to this.
ReplyDeleteThat is, until NASS etc, develop a specific CPT code for lateral techniques.
Where is DLIF in all this?
XLIF, DLIF or what ever else the companies will call their new products are just that, new products for a new procedure. A lateral approach to the spine that does not require an access surgeon. If anything this is a modified or minimally invasive thorasic approach.
ReplyDeleteThe procedure itself is performed either by an extracavitary lateral approach or anterior/ anterior lateral approach for spinal fusion. XLIF, DLIF, ALIF are acronyms for the procedures and if used as a marketing tool, you need to be sure that the procedure is classified correctly. Insurance carriers are reading the operative notes for the approach and access to the spinal column. We have been told to correct our codes to represent the approach dictated in the operative notes; ie; represent the extracavitary lateral procedure when in fact the op note states just that. The carriers have denied the anterior codes in these cases because they do not represent the procedure performed. They are not accepting the NASS guidelines as the general rule. We bill out the cases with the appropriate codes that correlate to the operative report, regardless of the manufacturer or the product name.
ReplyDelete