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How to report 22854 insertion of intervertebral biomechanical device per segment

Gina Posted Mon 12th of November, 2018 19:01:56 PM
When reporting 22854, is this being reported for each level of corpectomy if multiple levels of corpectomy was performed? It replaced the code 22851 which used to be reported per vertebral defect/segment. The code 22854 description says, “each contiguous defect”, does this mean if corpectomies were done on L4 and L5, device inserted on each level, do we code for 22854 x2 units or just one unit since it is a contiguous defect. Another question, when multiple level corpectomies was done, and an expandable device was inserted to span to all levels, should it be reported as one unit since it is only one device?
SuperCoder Answered Tue 13th of November, 2018 04:12:52 AM

A vertebral segment describes the basic constituent part into which the spine may be divided. It represents a single complete vertebral bone with its associated articular processes and laminae. A vertebral interspace is the non-bony compartment between two adjacent vertebral bodies, which contains the intervertebral disc, and includes the nucleus pulposus, annulus fibrosus, and two cartilaginous endplates.

When counting vertebral segments, be mindful that a single interspace sits between two vertebral segments. For instance, the span L1-L5 contains five vertebral segments (L1, L2, L3, L4 and L5) and four vertebral interspaces (L1/L2, L2/L3, L3/L4 and L4/L5). So, when corpectomies were done at L4 and L5, it will be considered as two segments, 2 units can be billed. On the other hand, code is described on the basis of segments, but not on the basis of device used. For the CPT 22854, 4 units can be billed on same date of service. Make sure your documentation supports selected codes.

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