Neurosurgery Coding Alert

Question: Our neurosurgeon used "Abbott" allograft bone for an anterior cervical discectomy and fusion (ACDF). I would code it as +20931 (Allograft for spine surgery only; structural ...), but he believes we should use +22851 (Application of intervertebral biomechanical device[s] [e.g., synthetic cage(s), threaded bone dowel(s), methylmethacrylate] to vertebral defect or interspace ...). He explains: "It is two separate pieces that the physician separately mills and contours. Afterward, the doctor glues them together to form a combination cortical/cancellous device. This device has a consistent size and strength rather than a piece of tricortical bone from a cadaver, which has inconsistent size and strength. A factory does this. The physician does the piece of tricortical iliac crest at the time of surgery. Thus, the milled biomechanical device comes that way." Who is correct? Washington Subscriber Answer: You are. According to the American Association of Neurological Surgeons (AANS), all allograft bone other [...]