MAY 2017

New Arthorodesis Codes for 2017

CPT code 22851 was deleted in 2017 and replaced with three new codes. The first code is 22853, which represents the insertion of a biomechanical device in conjunction with an interbody arthrodesis. What makes the new code set different from the old one is the inclusion of the phrase “with integral anterior instrumentation for device anchoring”. When an interbody device is inserted and then a separate plate with screws is attached to the vertebral body you would report the appropriate device insertion code and 22845 for the anterior fixation. Manufacturers have developed new types of cages which are called “integrated” because these devices have screws/flanges that are fixated to the vertebral endplates within the interspace to hold the cages in place. When the physician is inserting this type of device you can only report the biomechanical device insertion code – the integrated plating is included in the cage code so you cannot report 22845.

The second CPT code 22854, is reported when the physician first performs a corpectomy and then inserts the biomechanical device into the defect created by the corpectomy as part of an arthrodesis procedure. In order to qualify the procedure as a corpectomy, the physician must remove 50% of the vertebral body.

The last CPT code is 22859 and this code would be reported when a biomechanical device is inserted but no arthrodesis is being performed.

With all of the new devices on the market it is important to be able to identify a regular cage versus an integrated cage in order to correctly report these services.


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