Neurosurgery Coding Alert

Question: When our surgeons complete anterior cervical fusion (ACF) they insert a titanium spacer and use screws to place a plate over it. Can you explain how I should code the spacers?

Indiana Subscriber

Answer: Your coding will depend on the type of spacer used, but many call for +22851 (Application of intervertebral biomechanical device[s] [e.g., synthetic cages[s], threaded bone dowel[s], methylmethacrylate] to vertebral defect or interspace [List separately in addition to code for primary procedure]). Spacers that qualify for +22851 include PEEK, BAK, HARMS, Branigan, and titanium cages; LT cage lumbar fusion devices: carbon fibered intervertebral devices; and trabecular metal graft synthetic spacers.

Other option: If the surgeon uses a structural allograft as a spacer, report +20931 (Allograft for spine surgery only; structural [List separately in addition to code for primary procedure]).