Orthopedic Coding Alert

Question: When coding 22851 (Application of intervertebral biomechanical device[s] [e.g., synthetic cage(s), methylmethacrylate] to vertebral defect or interspace [List separately in addition to code for primary procedure]) and 22552 (Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace [List separately in addition to code for separate procedure]) multiple times in an operative session, is it appropriate to use units or should each procedure be listed separately?\

New Mexico Subscriber

Answer: You report +22851 for synthetic cages and threaded bone dowels. You report this code once per interspace. For example, if your surgeon places two cages or three bone dowels at interspace T11-T12, you should report a single unit of +22851.

You may report additional units of +22851 for additional interspaces your surgeon treats. For instance, if your surgeon places two cages at T11-T12 and a third cage at T12-L1, you may report +22851 x 2.

For some payers, you may have to append modifier -59 (Distinct procedural service...) to the second unit of 22851 to indicate that it represents instrumentation placed at a separate anatomic location.

You may adopt the same rules for +22552.