Wiki CPT 22558 and 22859

[CoderinJax]

Hello, question re: usage of CPT 22558 and 22859 on the same interspace/level (we'll use L2-L3).

DX lateral disk herniation, status post diskectomy, presents with recurrent herniation.

My provider performed an extreme lateral interbody fusion with PEEK cage placement and anterior instrumentation and billing 22558 for fusion, 22845 for instrumentation, and 22859 for cage. I am thinking 22853 is accurate for cage, not 22859 based on description since interbody fusion took place on same level.
****My confusion is due to CPT verbiage that shows that 22859 can be used with CPT 22558.

Can anyone help make this clear for me either way please? Thank you!

 

[amyjph]

The CPT description of 22859 specifically states "without interbody arthrodesis" so would not make sense to see at the 22558 level. Would be 22853.

Where do you see this? Are you talking about the code first instruction? "****My confusion is due to CPT verbiage that shows that 22859 can be used with CPT 22558."

There might be a case where they are doing a multi-level but the interbody is not at every level. So maybe the first level is 22558 but then there are additional vertebral bodies removed but no fusion where they had to place a cage.

 

[CoderinJax]

The CPT description of 22859 specifically states "without interbody arthrodesis" so would not make sense to see at the 22558 level. Would be 22853.

Where do you see this? Are you talking about the code first instruction? "****My confusion is due to CPT verbiage that shows that 22859 can be used with CPT 22558."

There might be a case where they are doing a multi-level but the interbody is not at every level. So maybe the first level is 22558 but then there are additional vertebral bodies removed but no fusion where they had to place a cage.

Hi Amy! Thanks for the response!
In the CPT book in the parenthetical notes for 22859 is where it lists that 22859 can be added to 22558 (it gives several ranges of Use in conjunction with... CPT codes). I was thinking the same thing about potentially a multi-level fusion like the scenario you mentioned, but wanted someone else's input because of the way the note lists it. I feel better in my thoughts and just needed someone else's input before I gave feedback. Thank you so much!