Answer: No. First, an incision is made over the anterior neck. Soft tissues and muscles are separated to expose the spine. Cervical Arthroplasty Procedure Description CPT Code Modifier Comments Total Disc Arthroplasty, Anterior Approach, Cervical 22856 single interspace Laminoplasty Procedure Description CPT Code Modifier Comments The new Category I codes for the Intracept Procedure are: 64628: Thermal destruction of intraosseous basivertebral nerve, including all … CPT Code For Anterior Cervical Discectomy And Fusion Anterior cervical discectomy and fusion is a surgical procedure that is performed to remove a herniated disk. The indications for surgery were cervical disc herniation caused by neck … Anterior cervical discectomy and fusion (ACDF) has emerged as the most commonly performed surgical treatment for degenerative cervical spine disease. The clinical trial involved 397 patients (209 patients who received the Prestige LP Cervical Disc at two adjacent … The patient is a 45-year-old male with a 1-year history of worsening mechanical neck pain and bilateral pain and numbness in a C8 distribution. "The anterior or anterolateral approach technique arthrodesis series of codes (22548-22585) are intended to describe arthrodesis performed via an open surgical approach. Anterior lumbar interbody fusion (ALIF) at L4-L5 with insertion of PEEK device packed with morselized allograft Code(s): 8. 209.63 209.63 1/1/2022 12/31/9999. • A cervical spine MRI or CT scan with myelogram within the past 12 months demonstrates spinal stenosis or nerve root compression at the same level as the symptoms and physical exam findings . Click to see full answer. Direct Lateral Interbody Fusion (DLIF): Uses a similar approach as XLIF. Artificial Cervical Disc Placement. Policy. 0.47520000000000001 40 0 0. Two codes are assigned for the anterior spinal fusion, as two levels of the spine were fused (L4-L5 and L5-S1). 20930 – Allograft, fragmented or bone promoting material placement. This means that CPT code 20660 is not reportable with CPT code 22551 “Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2” (aka ACDF) which is reported for the anterior cervical discectomy and fusion code. Co je kód postupu 22845? 0SG10AJ Fusion of 2 or more lumbar vertebral joints with interbody fusion device, posterior approach, anterior column, open approach 0SG10J0 Fusion of 2 or more lumbar vertebral joints with synthetic substitute, anterior approach, anterior column, open approach Single or multilevel anterior cervical discectomy and fusion (ACDF) is considered medically necessary for treatment of symptomatic degenerative disease when ALL of the following criteria are met: Page 2 of 14 Procedure CPT code1 Procedure description Anterior fusion 22551 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy, and decompression of spinal cord and/or nerve root(s); cervical below C2 22552 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy Additional Information. use a burr to remove osteophytes from the anterior aspect of the vertebra. V. Cervical Posterior Decompression (w/o fusion): VI. • A cervical spine MRI or CT scan with myelogram within the past 12 months demonstrates spinal stenosis or nerve root compression at the same level as the symptoms and physical exam findings . A total of 182 patients were treated with anterior cervical discectomy and fusion using Osteocel Plus in a PEEK (polyetheretherketone) cage and anterior plating at 1 or 2 consecutive levels. 0SG10AJ Fusion of 2 or more lumbar vertebral joints with interbody fusion device, posterior approach, anterior column, open approach 0SG10J0 Fusion of 2 or more lumbar vertebral joints with synthetic substitute, anterior approach, anterior column, open approach cervical endoscopic decompression with microforaminotomy (e.g., Jho procedure) (CPT codes 22899, 64999) endoscopic, anterior cervical disc decompression (e.g., Cervical Deuk Laser Disc Repair) (CPT codes 22899, 64999) PERCUTANEOUS LAMINECTOMY AND DISC DECOMPRESSION PROCEDURES of the CERVICAL, THORACIC, OR LUMBAR SPINE Relievant Medsystems, a company transforming chronic low back pain (CLBP) treatment, announced new Category I Current Procedural Terminology (CPT) codes for the Intracept Procedure are in effect as of January 1, 2022. A prospective, multicenter, randomized, concurrently controlled, noninferiority clinical trial to compare the safety and effectiveness of instrumented Bio2 Vitrium Cervical Interbody Device in anterior cervical discectomy and fusion (ACDF) with structural allograft bone and local autologous bone graft in treating patients with a symptomatic degenerative cervical … The same nomenclature is applied to the usually associated spinal fixation procedure. A sagittal section of the cervical spine shows disc herniations at C3-4 and C4-5 compressing the spinal canal. A graft is used for the fusion of bones and disc. Clinical Presentation . Cervical spine injury Anterior cervical fusion may be considered medically necessary for treatment of a cervical spine injury (eg, trauma) when ALL Otherwise you only code for the fusion, 22558. Age designations are assigned to select World Health Organization (WHO) International Classification of Diseases, Tenth Revision ICD10-CM) codes based on code descriptions or on publications and guidelines from sources such as professional specialty societies, the Centers for … 38.93 38.93 1/1/2022 12/31/9999. plate should span from the middle or proximal portion of the superior vertebra to the middle or inferior portion of the distal vertebra. Clinical outcomes included visual analog scale (VAS) for neck and arm pain, neck disability index, and SF-12 physical and mental component scores. Methods. Quick reference guide for CPT codes for thoracic spine procedures. Select appropriately sized plate. However, additional anterior instrumentation (i.e., plate, rod) unrelated to Anterior Cervical Discectomy & Fusion (ACDF) Overview. A fusion surgery is almost always done at the same time as the discectomy in order to stabilize the cervical segment. We think the correct codes are: 22551 (anterior cervical discectomy and decompression), 22856 (total disc arthroplasty) and 76000 (fluoroscopy). Anterior cervical discectomy [disk-EK-tuh-mee] and fusion (ACDF) is a surgery for treating damaged or worn discs in your neck. During the procedure, one or more dysfunctional discs are removed, and then two or more vertebrae are stabilized and fused together. Cervical Artificial Disc Replacement (Single or Two Level) VII. 20 22830 Exploration of fusion Procedure CPT code1 Procedure description Anterior fusion 22551 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy, and decompression of spinal cord and/or nerve root(s); cervical below C2 22552 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy Discectomy is coded in ICD-10-PCS as an excision or a resection. Introduction. July 7, 2016. FAQ: What is the CPT code for cervical fusion? 0.47520000000000001 40 0 0. An incision is made in the throat area to reach and remove the disc. For posterior (PLIF) or transforaminal (TLIF) approach lumbar interbody fusions, CPT code 22630 is used, and the dissection needed to access the disc space in these approaches is considered an incidental component of the fusion procedure. Anterior Cervical Discectomy Fusion; Transforaminal Lumbar Interbody Fusion; Cervical Disc Replacement; ... Medicare patients should be aware that spinal cord stimulators have been approved under CPT code 63650. The degenerative or herniated disk in neck requires removal by making a small incision on the throat. SKU: C11010. 22845 – Anterior instrumentation. Single-level cervical disc arthroplasty procedures are currently described by CPT code 22856: Total disc arthroplasty (artificial disc), anterior approach, including discectomy with endplate preparation (includes osteophytectomy for nerve root or spinal cord 22552 – ACDF added. Excisional discectomy is partial removal of the disc (removal of free fragments, removed the displaced disc, excised the disc or partial discectomy). This exhibit depicts a Cloward procedure C5-6 anterior discectomy and fusion procedure. Thank you for your response. By Benjamin Noah January 20, 2022. redeem code 22551 for the 1st Street Fusion level and discectomy performed and additional code 22552 for the following levels. The CPT code is 63075 and 22554 Excisional discectomy is partial removal of the disc (removal of free fragments, removed the displaced disc, excised the disc or partial discectomy). For 2011, CPT combined these two procedures into one new code. re: anterior cervical corpectomy. Fusion of spine, cervical region. CPT 22842 is for posterior instrumentation of 3 to 6 segments while CPT 22846 is for anterior instrumentation of 4 to 7 segments just to give a couple examples. 22552 – ACDF added. Introduction. Background context: The natural history of cervical degenerative disease with operative management has not been well described. Reduction of Kyphotic Deformity. Cervical radiculopathy is a clinical condition characterized by unilateral arm pain, numbness and tingling in a dermatomal distribution in the hand, and weakness in specific muscle groups associated with a single cervical nerve root. 22853 x 2 – Place devices. Create a contoured surface. Fusion of spine, cervical region. Ice packs applied for 15 to 20 minutes each hour for 4 consecutive hours may provide significant improvement in symptoms. 20 22830 Exploration of fusion Why do I need it? A graft is inserted to fuse together the bones above and below the disc. Integral anterior instrumentation to anchor the device to the intervertebral disc space when performed is not separately reportable. Therefore, code 22899, Unlisted procedure, spine should be reported. The Interbody space is part of the anterior column of the spine. Therefore an L4-L5 spinal fusion is actually a one level spinal fusion and, an L3-4, L4-5 spinal fusion is a two level spinal fusion. 22552 – Additional ACDF. The 2022 edition of ICD-10-CM M43.22 became effective on October 1, 2021. This is an open procedure in which the cervical spine is approached through an incision in the anterior neck. Answer: Take a look at 21501 (Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax) to see if it meets your needs. Anterior Cervical Discectomy with fusion (ACDF) - 2 Level. Spinal fusion may be done in the cervical, thoracic or (most commonly) lumbar areas of the spine. For example, a CPT code for echocardiogram consists of 5-digit numeric codes, which doctors, hospitals and other healthcare providers use to reference services performed. 1 The procedure is generally successful, and the incidence of major morbidity is low. performed by separate providers. I also had movement of the screws at both levels. CPT Codes Anterior Cervical Decompression with Fusion (ACDF) Single level 22548 Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2, with or without 2) 22220-22226 -Anterior approach, including discectomy, cervical, thoracic, lumbar, and each additional segment Other Excision of Bone Codes Used … Anterior cervical discectomy with fusion at C3-C4 with structured allograft body graft Code(s): Adeno Snot create ents of the an add-on Code(s): 4. We are just starting to do these procedures and I want to get our coding sorted out. This list presents Current Procedural Terminology (CPT®) coding examples for common spine procedures. ... Interbody fusion = anterior column ... - fusion 2 or more cervical vertebral joints with autologous tissue, posterior approach, posterior column; 0RG4071 I had a 2-level anterior cervical discectomy and fusion September 24, 2008, C-4/5, 5/6. Subsequent surgery rates after cervical total disc replacement using a Mobi-C Cervical Disc Prosthesis versus anterior cervical discectomy and fusion: a prospective randomized clinical trial with 5-year follow-up. The 5/6 level fused and the 4/5 did not. After anterior cervical discectomy, reduction, allograft placement, and instrumentation, a total of 92 (96%) patients had achieved satisfactory realignment. Pain relief is not limited to medication. The herniated C5-6 disc is then removed, and bilateral foraminotomies are performed to decompress the nerve roots. Clinical Presentation . How would you code for an L3 vertebrectomy with discectomy and decompression via an anterior approach? There is no anterior lumbar decompression code. A discectomy is a form of surgical decompression, and so the procedure can also be named an anterior cervical decompression. I looked at 22010 but that’s for a posterior procedure. Anterior cervical discectomy and fusion (ACDF) is a type of neck surgery that involves removing a damaged disc to relieve spinal cord or nerve root pressure and alleviate corresponding pain, weakness, numbness, and tingling. Fusion of spine, cervical region. In conclusion, cervical cord compression caused by lesions located principally in the anterior aspect of the spinal canal may be completely relieved via anterior vertebrectomy, discectomy, removal of the calcified ligament, and fusion. When a partial corpectomy (vertebral body resection) is performed at C5 and C6 report CPT code 22554 for the arthrodesis with 63081 and 63082. In the cervical spine, the amount of bone removed is defined as at least one-half of the vertebral body. 22551 – Anterior interbody fusion. This means that CPT code 20660 is not reportable with CPT code 22551 “Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2” (aka ACDF) which is reported for the anterior cervical discectomy and fusion code. In this procedure, a surgeon removes the damaged disc, relieving pressure on pinched nerves, and fills empty disc space with bone. Anterior cervical discectomy and fusion (ACDF) remains the standard of surgical treatment to help physicians interpret the diagnosis and avoid rehospitalization . Codes 2. The 2022 edition of ICD-10-CM M43.22 became effective on October 1, 2021. One patient died because of agranulocytosis secondary to treatment with antibiotics. 0.47520000000000001 40 0 0. Over a 9-year period, the author performed 574 ACDF procedures (697 levels). GENE.00023 Gene Expression Profiling of Melanomas; LAB.00031 Advanced Lipoprotein Testing disc, or the L4-5 level. Answer: To code for a lumbar corpectomy, you have to document removal of at least 1/3 of the vertebral body. Methods: Thirty-six patients who underwent anterior cervical discectomy and fusion (ACDF) performed using endoscopic surgery were selected for this study. M43.22 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Anterior cervical discectomy with fusion (ACDF) is a common surgery to relieve nerve and spinal cord compression in the neck. Anterior cervical discectomy and fusion is currently the gold standard treatment for herniated cervical disks. What is procedure code 22845? Anterior Cervical Discectomy and Fusion (ACDF) A surgical procedure from the front of the neck in which an interbody spacer is inserted into the disc space to support fusion. If the surgeon removes 1/2 the vertebral body at C4 and performs a fusion at C4-C5, wouldn't that be 63081 and 22554. the CPT® 22551 would actually be at level C5-C6 … Contents hide. A graft is used for the fusion of bones and disc. If you choose to access other websites from this website, you agree, as a condition of choosing any such link or access, that Arkansas Blue Cross and Blue Shield (ABCBS) is not and shall not be responsible or liable to you or to others in any way for your decision to link to such other websites. The patient is a 45-year-old male with a 1-year history of worsening mechanical neck pain and bilateral pain and numbness in a C8 distribution. What is the CPT code for anterior cervical fusion? (2019) 2 conducted a prospective, prospective, randomized, controlled, multicenter FDA-approved clinical trial, assessing the 10-year clinical safety and effectiveness of cervical arthroplasty compared to anterior cervical discectomy and fusion (ACDF). Self-retaining Cloward retractors are placed to expose the C5-6 disc space. Douglas Blaty, DO, Inland Northwest Spine and Neurosurgery . What is Coverage Policy? 2016;24(5):734-745. This report compares patient satisfaction rates between autograft and graft substitutes for anterior cervical discectomy and fusion (ACDF). A discectomy is a form of surgical decompression, and so the procedure can also be named an anterior cervical decompression. M43.22 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 20930 – Allograft, morselized, or placement of osteopromotive material. Should the complete discectomy be coded separately? This means that CPT code 20660 is not reportable with CPT code 22551 “Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2” (aka ACDF) which is reported for the anterior cervical discectomy and fusion code. performed by separate providers. 22853 x 2 – Place devices. CODING The coding listed in this medical policy is for reference only. Gornet, et al. I had a 2-level anterior cervical discectomy and fusion September 24, 2008, C-4/5, 5/6. When a discectomy is performed to decompress the spinal cord and/or nerve root(s) report 22554 for the arthrodesis along with 63075 for the discectomy procedure. Fusion refers to the bone graft that is used to fuse the C5 and C6 vertebrae together. +22552 for additional level. Number: 0743. Anterior Cervical Plate Fixation. 22552 – ACDF added. The most common procedure for cervical discectomy is anterior cervical discectomy. As we begin to look at some of the CPT code descriptions for spinal instrumentation, we see why accurately counting the total number of segments is important. CPT Codes. The degenerative or herniated disk in neck requires removal by making a small incision on the throat. Part 8: Spinal Fusion Coding — Discectomy During Spinal Fusion. The thin layer of platysma muscle that lies under the skin is cut and moved aside. Jackson RJ, Davis RJ, Hoffman GA, et al. 2 Historically, patients were admitted for a 2-4 day inpatient hospital stay post-operatively, the principal advantage of which is close monitoring of the … An anterior cervical fusion is done following the cervical discectomy. 0.47520000000000001 40 0 0. An ice pack may be especially helpful after any activity-related pain. This study was performed with the approval of the local area health network ethics committee. The CPT code is 63075 and 22554 At the bottom of the page, you will see related CPT codes and references. We will be doing a cervical discectomy with decompression under fluoroscopy and implanting the artificial disc. It is a misuse of anterior instrumentation CPT codes (e.g., 22845-22847) to report this integral anterior instrumentation.
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