Neurosurgery Coding Alert

Question: Which code should I use to describe placement of artificial disks? I'm leaning toward 22851, but my surgeon favors 22899.


Texas Subscriber
Answer: Beginning July 1, 2005, you will be able to choose a category III (HCPCS) code to describe total disk arthroplasty (placement of artificial disk), but in the meantime, your best code choice is probably 22899 (Unlisted procedure, spine). Remember to include complete documentation with the claim, along with your payment request.

Code 22899 is slightly more accurate than 64999 (Unlisted procedure, nervous system), because the procedure affects the bony structures more than the neural. But, either 22899 or 64999 will have the effect of flagging the claim for manual evaluation and processing.

And 22851 (Application of intervertebral biomechanical device[s] [e.g., synthetic cage(s), threaded bone dowel(s), methylmethacrylate] to vertebral defect or interspace) does not properly describe placement of an artificial disk. CPT guidelines clearly state, "Do not select a CPT code that merely approximates the service provided." In other words, a "next best" code isn't appropriate to describe an unlisted procedure or service.
 Therefore, if no appropriate procedure or service code exists, you should report the service using the appropriate unlisted-procedure code.