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The following article is written by Stephanie Ellis, RN, CPC, president of Ellis Medical Consulting.
Cage implants are used in fusion procedures to replace the vertebral body the surgeon resects during the procedure to provide support of the spine. Use code 22851 for synthetic (sometimes referred to as PEEK) cages implanted during fusion procedures.
Per CPT Assistant guidance, the 22851 code for cages is only to be billed once per spinal interspace area. Thus, if the physician inserts two cages at level L3-4 and one cage at level L4-5, bill the 22851 code twice (codes 22851 and 22851-59) for the case (Note: Do not bill the 22851 code three times because three cages were used).
Usually codes 20930 for morselized allograft or codes 20936 or 20937 are used for morselized autograft to fill in around the cages.
Learn more about Ellis Medical Consulting.
The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.
Related Articles on Spine Coding:
Surgery Center Coding Guidance: Spinal Instrumentation
Surgery Center Coding Guidance: Posterior/Posterolateral Fusions
Surgery Center Coding Guidance: PLIF and TLIF Procedures