Wiki Spinal fixation

[mkndevh@msn.com]

Does anyone know what types (i.e. PEEK) spinal fixation biomechnical devices (cages) require a plating system for stabilization? I code for anesthesia only and can't bill the new 22853, 22854, or 22859 because they don't hold any base units for anesthesia. We only can bill the plating systems if they're NOT an integral component of the cage. Normally op reports aren't specific enough to confirm if plate is truly a separate device or just being used for anchoring. Other than reaching out to the surgeons for each case I was trying to research and find info on what components the biomechnical devices include. Any ideas? TIA!!

 

[dwaldman]

Typically when the cage has associated screws, they will describe placing the cage then they will immediately start describing screws being placed in the vertebral bodies that appear to have connection to the cage.

When the plate is separate and not just for the cage to stay in place, you can see where they will mention a separate cage that has separate name and the screws (typically 4) that will attach that plate to hold it in place and the way the operative report describes the 4 screws that hold plate are describing be screwed in a different manner than they type of screws they used that are attached to cage.

This might not be the greatest response, but once you identify a specific surgeon describing a separate plate and the way they have place those screws it is evident it is different than they way they describe placing screws that are attached to the cage since those screws I believe go more in vertical fashion into the vertebral body.

I believe they should have more of clear examples with in the AMA CPT manual that address All in one devices versus a separate plate and more detail on what really is extensive versus the other code selections when it is one level and you are looking at newer version of instrumentation or Cages with screws that have come out past the inception of codes like 00670

 

[mkndevh@msn.com]

Thank you!