# Confused w/cpt 22845



## moodymom (May 12, 2009)

I am confused w/the description of cpt code 22845. It is described as Anterior instrumentation reserved for lumbar or thoracolumbar. It doesnt have any description for cervical spine. However I cant find a different anterior instumentation code. The book we are using is Ingenix 2009 coding companion.
                Thanks for the help


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## RebeccaWoodward* (May 12, 2009)

I think I understand your question...You're needing to know if 22845 can be used for the cervical region?

Here's a Q/A from CPT Assistant...

Question: What is the appropriate code to report if anterior instrumentation is inserted at vertebral segments C3-4 and additional instrumentation is inserted at C6-7, but vertebral segments C4-5 and C5-6 are not fused? Are the anterior instrumentation codes assigned strictly by the TOTAL number of spinal segments with instrumentation applied (ie, 22846) or is the appropriate code chosen based on the vertebral segments involved in each separate construct (ie, 22845, 22845 59)? 

Answer: Anterior instrumentation codes 22845-22847 may be reported separately with modifier 59, Distinct procedural service, appended when the procedure involves the work of putting two separate plates in the spine at different locations. Therefore, in this clinical scenario, it would be appropriate to report CPT code 22845, Anterior instrumentation; 2-3 vertebral segments, for C3-4 and CPT code 22845 with modifier 59 for C6-7.


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## jdemar (May 12, 2009)

Gina, I also use Ingenix Encoder and read the description and see the confusion but if you look under the code 22845 it list codes that you use with the instrumention...and it not just for the lumbar and thoracolumbar scoliotic cuves.....see 22220; 22318; 22554...all listed under 22845.  It may mean that is the only code for instrumentation for the scioliotic curves....curious to hear other coments?  I always use it for anterior instrm.


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## martnel (May 12, 2009)

I agree with jmdemar.  That's what I use.


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## MsRayRay (Aug 31, 2016)

*Cpt 22845*

Can CPT 22845 be billed in an Outpatient setting?
surgery was changed intra-operatively. The plan was to do an artificial disc replacement. However, because of the inadequately of the disc space, he was unable to do the disc replacement and elected to do a cervical fusion. CPT code 22845 is usually done on an in-pt basis, but more and more payers are requiring it to be done out-patient, so it can be billed as an out-patient procedure also. 
I am looking for some supporting documentation to show that for DOS 5/27/2016 CPT 22845 can be billed w/ POS 22
Do you know where I can find this type of information?
I appreciate your help with this.


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