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Spine surgery billing is level-by-level work. Fusion, decompression, instrumentation, interbody devices and bone graft each have their own code and their own bundling relationship, and payers expect documented conservative care and imaging correlation before approving the case. The claim pays when the operative note and authorization match code for code.
Spine coding has its own structure and its own payer scrutiny, and these points decide most outcomes.
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
The authorization lacked physical therapy, injections or medication trials over the payer's required period. Core MB assembles the treatment timeline with dates and outcomes before submitting the authorization request.
Add-on levels were billed but the note described one interspace. Core MB codes from the operative detail and queries the surgeon when levels in the note and the claim disagree.
Modifier 80 or AS billed on a code the payer lists as not eligible for an assistant. Core MB checks assistant eligibility per code and payer before submission and appeals when supported.
Core MB codes spine cases from the operative report with a level worksheet, verifies every add-on against NCCI, and runs authorization with the conservative care documentation each payer expects. Credentialing for spine surgeons and physician assistants runs in the same client portal. Credentialing for new providers runs in the same system, tracked live in your client portal.
Core MB manages the full spine surgery revenue cycle, from pre-authorization and operative coding through posting, appeals, patient balances and reporting on surgical collections.
Under NCCI, 63047 is bundled into 22630 and 22633 at the same interspace because the interbody approach includes the decompression. It can be billed with 22612 posterolateral fusion when the note documents a distinct decompression, and at a different level with modifier 59 or XS. Core MB applies the edit level by level.
Commercial spine policies list specific indications, such as spondylolisthesis with instability or failed prior decompression, and require conservative treatment duration and in some cases smoking cessation. Core MB reviews the policy before authorization, documents the matching indication and appeals clinical denials with the policy criteria cited.
Single-level cervical arthroplasty bills 22856 and a second level uses the add-on 22858. Payers require the specific device, a single or two-level indication and no prior fusion at the level. Core MB confirms the authorized code matches the planned procedure and that the implant documentation is in the note.
Submit the quote form with your case volume, payer mix and current billing arrangement. Core MB reviews a sample of operative notes and claims, builds your level coding workflow and transitions alongside your current billing. Credentialing for surgeons and assistants can start at the same time.
Core MB codes every fusion, decompression and add-on from the operative note, authorizes with the right documentation and defends claims through appeal.