Replacement codes for 22851

SJMarra

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I have seen all of the new replacement codes for 22851. There are codes for anterior with arthrodesis however, all of the posterior codes are without arthrodesis and without fusion. What code will be used for the posterior placement of a cage with arthrodesis/fusion?
 

sarab86

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All of these codes are NOT approach specific. I did the KZA webinar about the new codes and Kim Pollock explained them. The codes actually say "with integral anterior instrumentation for device anchoring, when performed" which only mean that if you are using the combo interbody/plate(i.e. Prevail Cage) then you would only use this code and not separately bill the plate. You are not required to use anterior anchoring for this code, only when performed. This is how I am going to use these codes.

22853-for ACDF, PLIF, PLIF/PLF Fusions
22854-Corpectomies
22859-This was explained to me for use for Spinal Reconstruction for stabilization or when there is a reconstruction after a tumor removal.

Hope this helps!
 

JLM929

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Replacment codes for 22851

I agree with Sarah, I too did attend the Webinar and that is how I perceived the information as well.
 

nauger

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What would you use for cage placement when doing a TLIF (CPT 22633) WITH interbody fusion?

CPT 22859 states WITHOUT interbody fusion. I am being directed to use the unlisted spine code 22899. Is that correct?
 

nauger

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The 22853 is with Anterior Instrumentation, the physician is doing it with Posterior Instrumentation...would 22853 still be the appropriate code?
 

nan.coder

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reporting 22845 with 22853 or 22854

If a physician is using two different vendors, one for the biomechanical device and different one for a plate, would reporting 22845 and 2283/22854 be correct coding. ASC Expert indicates this combination is not on the CCI edit list.

Thank you,

Nancy Boyle, CPC
 

sarab86

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The question you need to ask is...can the Anterior instrumentatinon device that crosses the intersace provide support and stand alone? if the "attached" plate/buttress screws or device cannot provide independent stabilization without being attached to the interboday device than it is not spearately billable. Keep in mind that the integral/combination plate/cages come in separate bags so you have to see if they can separately be used. Does that make sense? The use of 22845 with 22853/22854 is not any different than 22845 with 22851 you just now have a cage code for the different types of cases.
 
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