Insurance codes
 

Hello all, Thankfully Dr. Clavel provided me with the surgical note in English and I can do the currency exchange. I am uncertain about which codes to use:


22856 vs. 22858 Total disc arthro, anterior approach, including discectomy, end plate prep, removal of osteo for never and spinal cord decompression...


84.62 insertion of device


0090T one level cervical adr


0092T for each additional level

Input greatly appreciated. Thank you. Cheryl :confused:

I sent my first claim today
 

I got the codes and packaged it all and sent it today. I will update as soon as I hear anything...

CPT/ICD-9 codes as applicable
 

Additional comments or supporting documents *listed and attached

1. Letter of Conservative Treatments & Patient History
2. Medical Assessment, Treatment Plan & Medical Information regarding procedure
3. Procedural (Surgical) Notes & Diagnosis
4. Arrangements to pay for services: Funds obtained by loans: Bank wire confirmation
5. Itemized Statement in English
6. Euros to US Dollars Conversion

71020 chest x-ray
93000 Electrocardiogram, complete Routine ECG with at least 12 leads; with interpretation and report

V72.63 Pre-operative blood work-up
22856 Total disc arthroplasty (artificial disc), anterior approach, including discectomy with endplate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection), single interspace; cervical

22858 second level of cervical disc arthroplasty

Thanks for starting this thread Cheryl. I doubt my insurance will cover any of my surgery but, I'm sure I'll try anyway. I sure hope you are successful!

Colorado Babe said that the trick is to appeal immediately after they reject you. Not sure why the timing is so important. Perhaps she will add her two cents when she reads your thread. She just kept calling and pushing her cause.

All we can do is ask
 

The only thing I foresee needing later for an appeals process if denied reimbursement; would be documentation on the following:
1. Joint Commission Insurance accreditation for BSC and/or Hospital Quiron
2. ISO compliance
3. Statement showing that this procedure is the standard level of care in Spain and approved by your EMA

Does your insurance say that it will cover surgery abroad?

yes
 

50% of out of network. But I am sure they will have some stipulation on the when and why and how they cover it...