# 22853, 22854 use



## amittal.1314@gmail.com (Jan 12, 2017)

Hello,
The CPT 22851 has been replaced with 22853, 22854 -Which codes would I be able to use for insertion of a biomechanical device (cage) when used with arthrodesis CPT 22633 with POSTERIOR instrumentation...? since these both codes are described for anteiror instrumentation.. 
Any suggestions are appreciated.
Thank you


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## Paston@southdenverspine.com (Jan 16, 2017)

*Billing Manager*

There is now no specific code for posterior instrumentation with fusion, 22633.  We have to use 22899 (unlisted procedure).  I don't know if this was done on purpose or because of an oversight, but lets all make sure to bill the unlisted procedure code for posterior instrumentation with fusions, perhaps there will be an eventual correction.  Otherwise they may try to make the payment for posterior fusion instrumentation disappear.


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## hunterbht (Jan 17, 2017)

I would double check the AMA guidelines as set forth in the update(s).  In your example, the correct code would be to use 22853.  Also look at guidance from Karen Zupko's website:  

https://www.karenzupko.com/new-spinal-cage-codes-2017/

because the description mentions, ANTERIOR, the code is not exclusive to an anterior procedure.  

Hope this helps


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## Paston@southdenverspine.com (Jan 17, 2017)

This does help.  I have been getting so many different opinions!  Here is what I received back from a surgery authorization for an interbody fusion, 22633.  The surgery pre-auth was sent with the old code 22851:

22633
22851
22840 posterior non-segmental instrumentation

The insurance company stated that the code 22851 was no longer active and the appropriate code for placement of an interbody fusion prosthetic device for fusion is CPT 22853.  Karen Zupko uses the anterior plating CPT code 22845,which is anterior, so seeing the insurance company say the above with 22840 which is posterior, makes me believe that we can use these new codes for our posterior fusions as long as what is used for instrumentation meets the code criteria, (the plate crosses the interspace, provides independent stabilization and can be used with any other device.


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