Orthopedic Coding Alert

Question: Which code should I use to describe placement of artificial disks? I'm leaning toward 22851, but my surgeon favors 22899.


Texas Subscriber
Answer: Beginning July 1, 2005, you will be able to choose a category III (HCPCS) code to describe total disk arthroplasty (placement of artificial disk), as follows:
  0090T - Total disk arthroplasty (artificial disk), anterior approach, including diskectomy to prepare interspace (other than for decompression) single interspace; cervical
  0091T - Total disk arthroplasty (artificial disk), anterior approach, including diskectomy to prepare interspace (other than for decompression) single
interspace; lumbar
  +0092T - ... each additional interspace. In the meantime, your best code choice is probably 22899 (Unlisted procedure, spine). Remember to include complete documentation with the claim, along with your payment request.

Code 22899 is slightly more accurate than 64999 (Unlisted procedure, nervous system), because the procedure affects the bony structures more than the neural. But, either 22899 or 64999 will cause the insurer to flag the claim for manual evaluation and processing.

The bottom line is that 22851 (Application of intervertebral biomechanical device[s] [e.g., synthetic cage(s), threaded bone dowel(s), methylmethacrylate] to vertebral defect or interspace) does not properly describe placement of an artificial disk, so you should not bill it for your surgeon's disk placement.