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Pain Management & Spine Surgery Procedures OrthoNet PPA Code List Pain Management and Spine Surgery Procedures AND Effective 01/01/17 Major Joint and Foot/ Lower Extremity Procedures (Blue Medicare HMO PPO) CATEGORY PROCCODE PROCEDURE DESCRIPTION Pain Management & Spine Surgery Procedures Spinal Fusion 22510 Perq cervicothoracic inject Spinal Fusion 22511 Perq lumbosacral injection Spinal Fusion 22512 Vertebroplasty addl inject Spinal Fusion 22513 Perq vertebral augmentation Spinal Fusion 22514 Perq vertebral augmentation Spinal Fusion 22515 Perq vertebral augmentation Spinal Fusion 22532 LAT THORAX SPINE FUSION Spinal Fusion 22533 LAT LUMBAR SPINE FUSION Spinal Fusion 22534 LAT THOR/LUMB ADDL SEG Spinal Fusion 22548 NECK SPINE FUSION Spinal Fusion 22551 NECK SPINE FUSE&REMOV BEL C2 Spinal Fusion 22552 ADDL NECK SPINE FUSION Spinal Fusion 22554 NECK SPINE FUSION Spinal Fusion 22556 THORAX SPINE FUSION Spinal Fusion 22558 LUMBAR SPINE FUSION Spinal Fusion 22585 ADDITIONAL SPINAL FUSION Spinal Fusion 22586 Prescrl fuse w/ instr l5/s1 Spinal Fusion 22590 SPINE & SKULL SPINAL FUSION Spinal Fusion 22595 NECK SPINAL FUSION Spinal Fusion 22600 NECK SPINE FUSION Spinal Fusion 22610 THORAX SPINE FUSION Spinal Fusion 22612 LUMBAR SPINE FUSION Spinal Fusion 22614 SPINE FUSION, EXTRA SEGMENT Spinal Fusion 22630 LUMBAR SPINE FUSION Spinal Fusion 22632 SPINE FUSION, EXTRA SEGMENT Spinal Fusion 22633 LUMBAR SPINE FUSION COMBINED Spinal Fusion 22634 SPINE FUSION EXTRA SEGMENT Spinal Fusion 22800 FUSION OF SPINE Spinal Fusion 22802 FUSION OF SPINE Spinal Fusion 22804 FUSION OF SPINE Spinal Fusion 22808 FUSION OF SPINE Spinal Fusion 22810 FUSION OF SPINE Spinal Fusion 22812 FUSION OF SPINE Spinal Fusion 22818 KYPHECTOMY, 1-2 SEGMENTS Spinal Fusion 22819 KYPHECTOMY, 3 OR MORE Spinal Fusion 22830 EXPLORATION OF SPINAL FUSION Spinal Fusion 22840 INSERT SPINE FIXATION DEVICE Spinal Fusion 22841 INSERT SPINE FIXATION DEVICE Spinal Fusion 22842 INSERT SPINE FIXATION DEVICE Spinal Fusion 22843 INSERT SPINE FIXATION DEVICE Spinal Fusion 22844 INSERT SPINE FIXATION DEVICE Spinal Fusion 22845 INSERT SPINE FIXATION DEVICE Spinal Fusion 22846 INSERT SPINE FIXATION DEVICE OrthoNet PPA Code List Pain Management and Spine Surgery Procedures AND Effective 01/01/17 Major Joint and Foot/ Lower Extremity Procedures (Blue Medicare HMO PPO) CATEGORY PROCCODE PROCEDURE DESCRIPTION Spinal Fusion 22847 INSERT SPINE FIXATION DEVICE Spinal Fusion 22848 INSERT PELV FIXATION DEVICE Spinal Fusion 22849 REINSERT SPINAL FIXATION Spinal Fusion 22850 REMOVE SPINE FIXATION DEVICE Spinal Fusion 22852 REMOVE SPINE FIXATION DEVICE Spinal Fusion 22855 REMOVE SPINE FIXATION DEVICE Spinal Fusion 22856 CERV ARTIFIC DISKECTOMY Spinal Fusion 22857 LUMBAR ARTIF DISKECTOMY Spinal Fusion 22858 Second level cer diskectomy Spinal Fusion 22861 REVISE CERV ARTIFIC DISC Spinal Fusion 22862 REVISE LUMBAR ARTIF DISC Spinal Fusion 22864 REMOVE CERV ARTIF DISC Spinal Fusion 22865 REMOVE LUMB ARTIF DISC Spinal Fusion 22899 SPINE SURGERY PROCEDURE Pain Pump 62350 IMPLANT SPINAL CANAL CATH Pain Pump 62351 IMPLANT SPINAL CANAL CATH Pain Pump 62360 INSERT SPINE INFUSION DEVICE Pain Pump 62361 IMPLANT SPINE INFUSION PUMP Pain Pump 62362 IMPLANT SPINE INFUSION PUMP Decompression Surgery 63001 REMOVAL OF SPINAL LAMINA Decompression Surgery 63003 REMOVAL OF SPINAL LAMINA Decompression Surgery 63005 REMOVAL OF SPINAL LAMINA Decompression Surgery 63011 REMOVAL OF SPINAL LAMINA Decompression Surgery 63012 REMOVAL OF SPINAL LAMINA Decompression Surgery 63015 REMOVAL OF SPINAL LAMINA Decompression Surgery 63016 REMOVAL OF SPINAL LAMINA Decompression Surgery 63017 REMOVAL OF SPINAL LAMINA Decompression Surgery 63020 NECK SPINE DISK SURGERY Decompression Surgery 63030 LOW BACK DISK SURGERY Decompression Surgery 63035 SPINAL DISK SURGERY ADD-ON Decompression Surgery 63040 LAMINOTOMY, SINGLE CERVICAL Decompression Surgery 63042 LAMINOTOMY, SINGLE LUMBAR Decompression Surgery 63043 LAMINOTOMY, ADDL CERVICAL Decompression Surgery 63044 LAMINOTOMY, ADDL LUMBAR Decompression Surgery 63045 REMOVAL OF SPINAL LAMINA Decompression Surgery 63046 REMOVAL OF SPINAL LAMINA Decompression Surgery 63047 REMOVAL OF SPINAL LAMINA Decompression Surgery 63048 REMOVE SPINAL LAMINA ADD-ON Decompression Surgery 63050 CERVICAL LAMINOPLASTY Decompression Surgery 63051 C-LAMINOPLASTY W/GRAFT/PLATE Decompression Surgery 63055 DECOMPRESS SPINAL CORD Decompression Surgery 63056 DECOMPRESS SPINAL CORD Decompression Surgery 63057 DECOMPRESS SPINE CORD ADD-ON Decompression Surgery 63064 DECOMPRESS SPINAL CORD OrthoNet PPA Code List Pain Management and Spine Surgery Procedures AND Effective 01/01/17 Major Joint and Foot/ Lower Extremity Procedures (Blue Medicare HMO PPO) CATEGORY PROCCODE PROCEDURE DESCRIPTION Decompression Surgery 63066 DECOMPRESS SPINE CORD ADD-ON Decompression Surgery 63075 NECK SPINE DISK SURGERY Decompression Surgery 63076 NECK SPINE DISK SURGERY Decompression Surgery 63077 SPINE DISK SURGERY, THORAX Decompression Surgery 63078 SPINE DISK SURGERY, THORAX Decompression Surgery 63081 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63082 REMOVE VERTEBRAL BODY ADD-ON Decompression Surgery 63085 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63086 REMOVE VERTEBRAL BODY ADD-ON Decompression Surgery 63087 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63088 REMOVE VERTEBRAL BODY ADD-ON Decompression Surgery 63090 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63091 REMOVE VERTEBRAL BODY ADD-ON Decompression Surgery 63101 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63102 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63103 REMOVE VERTEBRAL BODY ADD-ON Decompression Surgery 63170 INCISE SPINAL CORD TRACT(S) Decompression Surgery 63172 DRAINAGE OF SPINAL CYST Decompression Surgery 63173 DRAINAGE OF SPINAL CYST Decompression Surgery 63180 REVISE SPINAL CORD LIGAMENTS Decompression Surgery 63182 REVISE SPINAL CORD LIGAMENTS Decompression Surgery 63185 INCISE SPINAL COLUMN/NERVES Decompression Surgery 63190 INCISE SPINAL COLUMN/NERVES Decompression Surgery 63191 INCISE SPINAL COLUMN/NERVES Decompression Surgery 63194 INCISE SPINAL COLUMN & CORD Decompression Surgery 63195 INCISE SPINAL COLUMN & CORD Decompression Surgery 63196 INCISE SPINAL COLUMN & CORD Decompression Surgery 63197 INCISE SPINAL COLUMN & CORD Decompression Surgery 63198 INCISE SPINAL COLUMN & CORD Decompression Surgery 63199 INCISE SPINAL COLUMN & CORD Decompression Surgery 63200 RELEASE OF SPINAL CORD Decompression Surgery 63250 REVISE SPINAL CORD VESSELS Decompression Surgery 63251 REVISE SPINAL CORD VESSELS Decompression Surgery 63252 REVISE SPINAL CORD VESSELS Decompression Surgery 63265 EXCISE INTRASPINAL LESION Decompression Surgery 63266 EXCISE INTRASPINAL LESION Decompression Surgery 63267 EXCISE INTRASPINAL LESION Decompression Surgery 63268 EXCISE INTRASPINAL LESION Decompression Surgery 63270 EXCISE INTRASPINAL LESION Decompression Surgery 63271 EXCISE INTRASPINAL LESION Decompression Surgery 63272 EXCISE INTRASPINAL LESION Decompression Surgery 63273 EXCISE INTRASPINAL LESION Decompression Surgery 63275 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63276 BIOPSY/EXCISE SPINAL TUMOR OrthoNet PPA Code List Pain Management and Spine Surgery Procedures AND Effective 01/01/17 Major Joint and Foot/ Lower Extremity Procedures (Blue Medicare HMO PPO) CATEGORY PROCCODE PROCEDURE DESCRIPTION Decompression Surgery 63277 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63278 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63280 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63281 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63282 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63283 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63285 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63286 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63287 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63290 BIOPSY/EXCISE SPINAL TUMOR Decompression Surgery 63295 REPAIR OF LAMINECTOMY DEFECT Decompression Surgery 63300 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63301 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63302 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63303 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63304 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63305 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63306 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63307 REMOVAL OF VERTEBRAL BODY Decompression Surgery 63308 REMOVE VERTEBRAL BODY ADD-ON Spinal Cord Stimulator 63650 IMPLANT NEUROELECTRODES Spinal Cord Stimulator 63655 IMPLANT NEUROELECTRODES Spinal Cord Stimulator 63661 REMOVE SPINE ELTRD PERQ ARAY Spinal Cord Stimulator 63662 REMOVE SPINE ELTRD PLATE Spinal Cord Stimulator 63663 REVISE SPINE ELTRD PERQ ARAY Spinal Cord Stimulator 63664 REVISE SPINE ELTRD PLATE Spinal Cord Stimulator 63685 IMPLANT NEURORECEIVER Spinal Cord Stimulator 63688 REVISE/REMOVE NEURORECEIVER Spinal Fusion 0195T ARTHROD PRESAC INTERBODY Spinal Fusion 0196T ARTHROD PRESAC INTERBODY EAC Spinal Fusion 0309T Prescrl fuse w/ instr l4/l5 Spinal Fusion 0375T Total disc arthrp ant appr Spinal Fusion 22853 INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD Spinal Fusion 22854 INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD Spinal Fusion 22859 INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD Spinal Fusion 22867 INSJ STABLJ DEV W/DCMPRN LUMBAR SINGLE LEVEL Spinal Fusion 22868 INSJ STABLJ DEV W/DCMPRN LUMBAR SECOND LEVEL Spinal Fusion 22869 INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE LEVEL Spinal Fusion 22870 INSJ STABLJ DEV W/O DCMPRN LUMBAR SECOND LEVEL Pain Pump 62324 NJX DX/THER SBST INTRLMNR CRV/THRC W/O
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