Anterior Plate Redo at C3-5


Peter Davidyock

I have a surgeon who placed a plate anteriorly at C3-5.
5 days later he anteriorly revised the plate and then posteriorly placed a rod at the same level.

I have the rod coding correct but I am curious about the plate redo.
I am considering 22849 but I am unsure if the approach will be enough to differentiate the plate redo. 22849 states not to report if performed at the same level. The rod that was inserted is at the same level but the appraoch was different. The rod insertion and plate redo were performed via different approaches. Will the appraoches dictate the codes or does the level ultimately decide what he can be reimbursed for?

I am not quite clear on how to proceed. Any spine guru's have any advice?