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My group had a conference call with Medicare where we pointedly asked certain questions. Yes, no facet procedures at ALIF or ACDF, even if posterior elements are untouched.
Yes, we bill by joints, so you can do either single level (2 Medial branch) or two level (3 medial branch) unilateral or bilateral RF. No 3 level (4 medial branch) unilateral or bilateral.
I'm still trying to figure out if this applies to the Medicare Advantage plans as well or just straight Medicare. Anyone have any info how this works?
I still get the impression that medicare does track the levels, but not whether or not there is a fusion present as that it is too hard for them to follow.
I sometimes do cervical RFA on patients s/p ACDF and s/p ALIF, and medicare still pays me.