Neurosurgery Coding Alert

Question: Our physician has documented Lanx’s Aspen Spinous Process Fixation.  Is it ok to consider this procedure to be synonymous with spinous process fixation by wiring? Can we report CPT® code 22841 for this procedure?

New York Subscriber

Answer: For placement of plate and screw fixation systems to the spinous processes, you should submit the unlisted code 22899 (Unlisted procedure, spine). Code 22841 (Internal spinal fixation by wiring of spinous processes [List separately in addition to code for primary procedure]) specifically refers to an interspinous wiring technique for fixation. This is an add-on code that you report with code for a primary procedure. 

What is Lanx’s Aspen Spinous Process Fixation System? The Aspen Spinous Process Fixation System is a fixation device that helps to eliminate interspinous motion. This device is used for a single level in the spine except the cervical region. This device is used with bone grafts and is not intended for standalone use. 

The Aspen Spinous Process Fixation device comprises a plate that your physician attaches to the spinous processes to supplement an interspinous fusion. Your physician may use this device in patients who suffer from degenerative disc disease, spondylolisthesis, spinal tumor, or other conditions. 

Your physician will typically make a small incision in the lower back and will then insert the Aspen device to position it behind the spinal elements and in between two spinous processes. This device placement helps to reestablish the alignment in the spine and stabilizes the spine.