Neurosurgery Coding Alert

Question: Our surgeons are using the LDR ROI-C plating system, which is a cage with two arrow like plates. However, the two plates do not span the interspace but are used with each single cage. They want us to bill both the cage, 22851 and plate, 22845. However, 22845 description indicates it is for 2 to 3 vertebral segments, when the devise is used for each individual segment.

Do the arrow plates qualify for plating as described in 22845? And if yes, how would we bill multiple levels as 22845 should not be billed multiple times?

Alaska Subscriber

Answer: When the fixation to the vertebral body is an integral part of the prosthetic interbody device, one would report only code 22851 (Application of intervertebral biomechanical device[s] [eg, synthetic cage[s], methylmethacrylate] to vertebral defect or interspace [List separately in addition to code for primary procedure]) for the prosthetic device placement. CPT® +22851 is an add-on code. You cannot report this code alone, it must be reported along with the primary code.