Wiki Intervertebral biomechanical device with separate anchoring

[Margaret R Mize]

CPT states that 22853 is an intervertebral biomechanical device with integral instrumentation. Our doctors use an intervertebral device that HAS NO INTEGRAL INSTRUMENTATION. Therefore we are billing 22853 along with one of the codes from 22840 through 22846 using the modifier -59 on the instrumentation codes. Of course it is a big deal because insurance companies deny the instrumentation codes stating that instrumentation is not needed with integral instrumentation from the device, 22853. CPT, I think, should give us another code for a device without instrumentation. Anybody else having trouble and is anyone actually getting paid for these codes used together?

 

[sarab86]

I am having the same problem. UHC completely avoids the line "when performed" in the description. I have been sending the CPT Assistant Newsletter from March 2017 that says that anterior instrumentation is NOT integral anchoring. However it has taken appealing to the executive office to get anyone to actually read the documents I send. Its a massive misinterpretation of the CPT description.