August 18, 2016

Question:
We have a billing company for which we bill for many different specialties. We have an orthopedic spine doctor who insists we bill the cage code 22851 for each inter-space. However, the CPT book lists as cage(s) therefore our thinking is that no matter how many are placed this code is only allowed one time per surgery. His note states “C3-C4, C4-C5, C5-C6 anterior cervical interbody fusion using PEEK titanium interbody spacers.”

Answer:
Your client is correct. CPT code 22851 is reported per interspace to describe intervertebral biomechanical devices, including PEEK cages. The term is both, single or plural, “cage(s)”, because sometimes there are two devices placed at a single spinal level. If you do an internet search on PEEK cages, you’ll find a variety of designs. As long as the supporting documentation in the body of the note is appropriate, the statement above supports 3 units of 22851. Remember that this CPT code is not subject to multiple procedure discounts.

*This response is based on the best information available as of 08/18/16.