How To Use CPT Code 22859

CPT code 22859 describes the insertion of intervertebral biomechanical device(s) to the intervertebral disc space or vertebral body defect without interbody arthrodesis. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 22859?

CPT 22859 is a code used to describe the insertion of intervertebral biomechanical device(s) to the intervertebral disc space or vertebral body defect without interbody arthrodesis. This procedure involves the placement of a metallic cage or mesh device to maintain the interspace and vertebral height, providing relief from persistent pain caused by a spinal condition. It is important to note that this code is an add-on code and must be reported with an appropriate primary procedure.

2. Official Description

The official description of CPT code 22859 is: ‘Insertion of intervertebral biomechanical device(s) (e.g., synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other primary procedure codes listed in the notes section.

3. Procedure

During the procedure, the healthcare provider first exposes the intervertebral disc or the vertebrae, depending on the specific case. The surrounding tissues and muscles are retracted to provide access to the targeted area. The provider then inserts a synthetic device, such as a cage or mesh, into the intervertebral disc space or over a defect in the vertebral body. This device helps expand or maintain the disc space and vertebral height, providing support and relieving pain. The procedure does not involve fusion or fixation of the vertebral bodies.

4. Qualifying circumstances

CPT 22859 is typically performed on patients who require treatment for intervertebral disc space or vertebral body defects without the need for interbody arthrodesis. It is important to note that this code should be used in conjunction with other primary procedure codes, as listed in the notes section. The provider must assess the patient’s condition and determine the appropriateness of using CPT 22859 based on the specific circumstances.

5. When to use CPT code 22859

CPT code 22859 should be used when the provider performs the insertion of intervertebral biomechanical device(s) to the intervertebral disc space or vertebral body defect without interbody arthrodesis. This code should be reported once for each contiguous defect treated in addition to the primary procedure code. It is important to ensure that the primary procedure code is reported accurately and that CPT 22859 is used as an add-on code.

6. Documentation requirements

To support a claim for CPT 22859, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the insertion of intervertebral biomechanical device(s)
• Specific details of the procedure, including the number of devices inserted and the location of the insertion
• Date of the procedure
• Start and end time of the procedure
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 22859, it is important to ensure that the procedure meets the criteria for this code. The provider should report CPT 22859 as an add-on code in conjunction with the appropriate primary procedure code. It is crucial to review the notes section to determine which primary procedure codes can be reported with CPT 22859. Additionally, it is important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 22859 was added to the Current Procedural Terminology system on January 1, 2017. There have been no updates to the code since its addition.

9. Similar codes to CPT 22859

There are several similar codes to CPT 22859 that may be used in different scenarios. These codes include:

• CPT 22853: Insertion of interbody biomechanical device(s) with integral anterior instrumentation for device anchoring to the intervertebral disc space in conjunction with interbody arthrodesis, each interspace
• CPT 22854: Insertion of intervertebral biomechanical device(s) with integral anterior instrumentation for device anchoring to vertebral corpectomy(ies) defect, in conjunction with interbody arthrodesis, each contiguous defect

9. Examples

1. A patient undergoes a spinal procedure, and the provider inserts a metallic cage into the intervertebral disc space to maintain the disc height and relieve pain.
2. During a vertebral body defect repair, the provider inserts a mesh device to cover the defect and provide support to the surrounding structures.
3. A patient with a spinal condition undergoes a procedure, and the provider inserts a synthetic cage into the intervertebral disc space to restore stability and alleviate pain.
4. During a spinal surgery, the provider inserts a metallic cage into the intervertebral disc space to maintain the disc height and improve the patient’s overall spinal alignment.
5. A patient with a vertebral body defect undergoes a procedure, and the provider inserts a mesh device to cover the defect and prevent further complications.
6. During a spinal fusion surgery, the provider inserts a synthetic cage into the intervertebral disc space to promote fusion and stabilize the affected area.
7. A patient with a spinal condition undergoes a procedure, and the provider inserts a metallic cage into the intervertebral disc space to restore disc height and alleviate pressure on the surrounding nerves.
8. During a vertebral body defect repair, the provider inserts a mesh device to cover the defect and provide structural support to the adjacent vertebrae.
9. A patient with a spinal condition undergoes a procedure, and the provider inserts a synthetic cage into the intervertebral disc space to improve spinal stability and alleviate pain.
10. During a spinal surgery, the provider inserts a metallic cage into the intervertebral disc space to restore disc height and improve the patient’s overall spinal alignment.