How To Use CPT Code 22853

CPT 22853 refers to the insertion of interbody biomechanical devices during a spinal interbody arthrodesis procedure, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 22853?

CPT 22853 is a medical billing code used to describe the insertion of interbody biomechanical devices, such as synthetic cages or mesh, with integral anterior instrumentation for device anchoring during a spinal interbody arthrodesis procedure. This code is used to report the procedure performed by healthcare providers to maintain the disc space, provide spinal stability, and preserve some range of motion, which helps relieve persistent pain caused by a herniated or bulging disc or other spinal conditions.

2. 22853 CPT code description

The official description of CPT code 22853 is: “Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)”.

3. Procedure

The procedure for CPT 22853 involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. During a primary interbody arthrodesis procedure, the provider exposes the intervertebral disc and retracts the surrounding tissues and muscles.
3. The provider inserts a synthetic device between two adjacent vertebrae to expand or maintain the disc space.
4. Screws or flanges on the device may be used to attach it to the vertebrae.
5. Once the planned number of devices is inserted, the provider continues the primary procedure to its completion, controls bleeding, and closes the wound.

Report this code once for each interspace that the provider treats in addition to the primary code for the procedure.

4. Qualifying circumstances

Patients eligible to receive CPT code 22853 services are those who have persistent pain caused by a herniated or bulging disc or other spinal conditions and require a spinal interbody arthrodesis procedure. The insertion of interbody biomechanical devices helps maintain the disc space, provide spinal stability, and preserve some range of motion, which can alleviate the patient’s pain.

5. When to use CPT code 22853

It is appropriate to bill the 22853 CPT code when the provider inserts an interbody biomechanical device during a spinal interbody arthrodesis procedure. This code should be reported once for each interspace treated, in addition to the primary code for the procedure. It is an add-on code and must be reported with an appropriate primary procedure.

6. Documentation requirements

To support a claim for CPT 22853, the following information should be documented:

• Patient’s medical history and diagnosis, indicating the need for a spinal interbody arthrodesis procedure.
• Details of the procedure, including the type of interbody biomechanical device used, the number of devices inserted, and the interspaces treated.
• Any complications or additional procedures performed during the surgery.
• Postoperative care instructions and follow-up appointments.

7. Billing guidelines

When billing for CPT code 22853, keep in mind the following guidelines:

• Report one unit of this code for each interspace treated, not for the number of devices inserted.
• Use 22853 in conjunction with appropriate primary procedure codes, such as 22548-22586 (Anterior or anterolateral approach technique arthrodesis procedures on the spine).
• Do not report 22853 for procedures that do not involve interbody fusion (arthrodesis).

8. Historical information

CPT 22853 was added to the Current Procedural Terminology system on January 1, 2017. There have been no updates since its addition.

9. Similar codes to CPT 22853

Five similar codes to CPT 22853 and how they differentiate are:

1. CPT 22854: Involves the insertion of a device to cover a defect created by the removal of a vertebral body.
2. CPT 22859: Refers to the insertion of a similar device to treat an intervertebral disc space or vertebral body removal defect but without interbody fusion (arthrodesis).
3. CPT 22548: Describes an anterior approach technique arthrodesis procedure on the spine.
4. CPT 22586: Refers to an anterolateral approach technique arthrodesis procedure on the spine.
5. CPT 22630: Involves a posterior or posterolateral approach technique arthrodesis procedure on the spine.

10. Examples

Here are 10 detailed examples of CPT code 22853 procedures:

1. Insertion of a synthetic cage between L4 and L5 vertebrae during a lumbar interbody arthrodesis procedure.
2. Insertion of a mesh device between C5 and C6 vertebrae with screws for anchoring during a cervical interbody arthrodesis procedure.
3. Insertion of two synthetic cages between L3 and L4 vertebrae during a lumbar interbody arthrodesis procedure.
4. Insertion of a mesh device between T7 and T8 vertebrae with flanges for anchoring during a thoracic interbody arthrodesis procedure.
5. Insertion of a synthetic cage between C3 and C4 vertebrae during a cervical interbody arthrodesis procedure.
6. Insertion of a mesh device between L5 and S1 vertebrae with screws for anchoring during a lumbar interbody arthrodesis procedure.
7. Insertion of a synthetic cage between T5 and T6 vertebrae during a thoracic interbody arthrodesis procedure.
8. Insertion of a mesh device between C6 and C7 vertebrae with flanges for anchoring during a cervical interbody arthrodesis procedure.
9. Insertion of a synthetic cage between L2 and L3 vertebrae during a lumbar interbody arthrodesis procedure.
10. Insertion of a mesh device between T9 and T10 vertebrae with screws for anchoring during a thoracic interbody arthrodesis procedure.