Look Into Interspaces Before Coding PEEK Cage Insertion
Question: Some of my surgeons are inserting polyether-ether-ketone (PEEK) cages bilaterally and wanting to report 2 units for the service. Is this allowed, or should we be reporting a single unit per PEEK cage? RCI Subscriber Answer: PEEK cages are used to treat various spinal conditions; surgeons use them as replacements for spinal discs, which can help fuse vertebrae. You might also see PEEK cages referred to as interbody cages. As to whether you can report multiple PEEK cage insertion codes, it depends on the number of interspaces the surgeon treated with PEEK cages. The code for PEEK cage insertion is +22853 (Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)). Obviously, you’ll need to report the appropriate base code for the main surgery performed before reporting +22853. The descriptor for +22853 reads “per interspace”; this means that you can only report +22853 once if the surgeon treated one interspace — even if they inserted two PEEK cages. In fact, to hammer the point home, the notes under +22853 in the CPT® code book read, “Report 22853 for each treated intervertebral disc space.” If, however, the surgeon inserted PEEK cages at two separate interspaces, you can report +22853 x 2 along with the base surgical code. Chris Boucher, MS, CPC, Senior Development Editor, AAPC
