Wiki 22853 spinal biomech device

London, OH
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Good Morning! Hoping to get some insight on new CPT 22853-22859 for spinal instrumentation biomechnical devices. I code for anesthesia only and deleted code 22851 had base units. New codes 22853-59 do not according to the 2017 Crosswalk for anesthesia. Could anyone tell me if the plating systems that support/anchor the cages/spacers are separately reportable or are they components of 22853? The following is a portion of op note where spacer is used with plating system. I don't normally code for spinal procedures, so I'm unfamiliar with what is all included in some of these codes. I believe 22851 included anchoring devices as components of the procedure. This was a two part surgery...this segment being the second. TIA!!!!

1. L4-5 retroperitoneal access for anterior lumbar interbody
2. L4-5 complete anterior diskectomy via retroperitoneal
3. L4-5 anterior arthrodesis with osteoAMP allograft, cellentra allograft.
4. L4-5 placement of PEEK biomechanical spacer infused with allograft for fusion.
5. L4-5 placement of anterior lumbar plating system with fixation screws x4 and
locking plates x4.

Once he confirmed the midline marking, as well as the lateral marking
at L4-5, I performing an annulotomy with a 15 blade on a long handle. Straight and curved curettes, double
action, were utilized to cleanse out disk. Curved curettes and straight
curettes were utilized to cleanse out disk as well. I used TLIF spacers
to indirectly elevate from 10 to 12 mm disk space. I additionally
removed disk thoroughly, and then worked to get a far lateral recess
toward the left side and right side, until I was able to withdraw a very large disk
herniation of the left lateral recess.
I then trialed up to a PEEK spacer, which was 12 mm tall and I packed this with allograft, and this was placed into
The disc space at L4-5. I placed fixation screws on a plate, which was a Lanx plate with 25 mm x
5.0 inferior and 30 mm x 5.0 cephalad with a locking plate at L4-5.
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