<p>20000-29999</p><p> Code 21076-21089 should only be used when the physician actually designs and prepares the prosthesis (i.e., not prepared by an outside laboratory)</p><p> To report bone graft performed after arthrodesis, see 20930-20938. Do not append modifier 62 to bone graft codes 20900-20938</p><p> Within the spine section, instrumentation is reported separately and in addition to arthrodesis. To report instrumentation procedures performed with definitive vertebral procedures, see 22840-22855. </p><p> Modifier 62 may not be applied to the definitive or add on spinal instrumentation procedure codes like 22840-22848 and 22850-22852</p><p> When arthrodesis is performed in addition to another procedure, the arthrodesis should be reported in addition to the original procedure with modifier 51.</p><p> Spinal osteotomy procedures are reported when a portion of the vertebral segments is cut and removal in preparation for realigning the spine as part of spinal deformity correction. </p><p> For excision of an intrinsic lesion of vertebra without deformity correction, see 22100-22116. For decompression of the spinal cord and/or nerve roots, see 63001-63308</p><p> The three columns are defined as anterior ( anterior two-thirds of the vertebral body), middle (posterior third of the vertebral body and the pedicle), and posterior (articular facets, lamina and spinous process)</p><p> Procedure codes 22554-22558 are for Single interspace.</p><p> For additional interspaces use 22585. A vertebral interspace is the non-bony compartment between two adjacent vertebral bodies, which contain the intervertebral discs and includes the nucleus pulposus, annulus fibrosus and two cartilaginous endplates.</p><p> When instrumentation reinsertion or removal is reported in conjunction with other definitive procedures including arthrodesis, decompression and exploration of fusion, append modifier 51 to 22849, 22850, 22852 and 22855.</p><p> Code 22849 should not be reported with 22850, 22852 and 22855 at the same spinal levels.</p><p> To report exploration of fusion, see 22830. When exploration is reported in conjunction with other definitive procedures, including arthrodesis and decompression, append 51 modifier to 22830.</p><p> Application of casts and strapping procedure are coded when the cast application or strapping is a replacement procedure used during or after the period of follow-up care, or when the cast application or strapping is an initial service performed without a restorative treatment or procedure to stabilize or protect a fracture, injury or dislocation and/or to afford comfort to a patient.  Restorative treatment or procedure rendered by another physician following the application of the initial cast/splint/strap may be reported with a treatment of fracture and/or dislocation code.</p><p> Initial cast/strap/splint procedure is always included in the treatment of fracture/dislocation codes.</p><p> Temporary cast/strap/splint is not considered to be part of the preoperative care and the use of the modifier 56 is not applicable.</p><p> Supply code for cast/strap/splint is 99070; it can be used in addition to evaluation and management code as appropriate.</p>