Neurosurgery Coding Alert

Question: I've always been of the understanding that you should bill +22851 per interspace. One of our payers rejected a claim with multiple units of +22851, stating it was a duplicate charge. Have there been changes we need to know?

Connecticut Subscriber

Answer: You are correct in reporting +22851 (Application of intervertebral biomechanical device[s] [e.g., synthetic cage{s}, threaded bone dowel{s}, methylmethacrylate] to vertebral defect or interspace [List separately in addition to code for primary procedure]) for each interspace treated.

For example, if the surgeon treats L3-L4 and L4-L5, you'll report one unit of +22851 for L3-L4 and one unit +22851 with modifier 59 (Distinct procedural service) for L4-L5. Ensure that your surgeon documents that he places cages or other prosthetic devices in each interspace.