Medicare Benefits Schedule - Note TN.8.147

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.147

Anterior and Posterior (combined) Spinal fusion under one anaesthetic via separate incisions - Items 51061 to 51066

Only one of these items should be billed for any appropriate combined anterior and posterior surgeries which are completed under one anaesthetic. The appropriate item is determined by the number of motion segments to which grafting and fusion occur.

These items cannot be claimed with any item between 51020 to 51026, 51031 to 51036 and 51041 to 51045.

If a laminectomy is included, an item from 51011 to 51015 can also be used appropriate to the level of decompression.

If spinal osteotomy or vertebrectomy (>50%) is performed as part of the combined anterior/posterior approach, it is appropriate to claim one item between 51051 to 51056 in addition to an item between 51061 to 51066.

Related Items: 51061 51062 51063 51064 51065 51066


Related Items

Category 3 - THERAPEUTIC PROCEDURES

51061

51061 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Spinal fusion, anterior and posterior, including spinal instrumentation at one motion segment, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51062, 51063, 51064, 51065 or 51066 applies

(Anaes.) (Assist.)

Fee: $2,923.20 Benefit: 75% = $2,192.40

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51062

51062 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Spinal fusion, anterior and posterior, including spinal instrumentation at 2 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51063, 51064, 51065 or 51066 applies

(Anaes.) (Assist.)

Fee: $3,789.15 Benefit: 75% = $2,841.90

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51063

51063 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Spinal fusion, anterior and posterior, including spinal instrumentation at 3 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51062, 51064, 51065 or 51066 applies

(Anaes.) (Assist.)

Fee: $4,589.35 Benefit: 75% = $3,442.05

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51064

51064 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Spinal fusion, anterior and posterior, including spinal instrumentation at 4 to 7 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51062, 51063, 51065 or 51066 applies

(Anaes.) (Assist.)

Fee: $5,107.60 Benefit: 75% = $3,830.70

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51065

51065 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Spinal fusion, anterior and posterior, including spinal instrumentation at 8 to 11 motion segments, posterior and/or posterolateral bone graft, and anterior column fusion, not being a service associated with a service to which item 51061, 51062, 51063, 51064 or 51066 applies

(Anaes.) (Assist.)

Fee: $5,648.95 Benefit: 75% = $4,236.75

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

51066

51066 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2020

Spinal fusion, anterior and posterior, including spinal instrumentation at 12 or more motion segments, posterior and/or posterolateral bone graft, and anterior column fusion not being a service associated with a service to which item 51061, 51062, 51063, 51064 or 51065 applies

(Anaes.) (Assist.)

Fee: $5,947.70 Benefit: 75% = $4,460.80

(See para TN.8.141, TN.8.147 of explanatory notes to this Category)


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change