2025 CPT code 22585
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spine Musculoskeletal System Feed
Each additional interspace arthrodesis (spinal fusion) using the anterior interbody technique, including minimal discectomy; reported in addition to the primary procedure code.
Modifier 51 may be appended to the primary procedure code if multiple procedures are performed during the same surgical session, though this is generally not necessary as 22585 is already an add-on code. Modifier 62 may be appended if two surgeons work together as primary surgeons performing distinct parts of the arthrodesis.
The medical necessity for this procedure is established by the presence of significant spinal instability, degenerative disc disease, or other conditions causing persistent pain and functional impairment that are not adequately managed by conservative treatment.Documentation should clearly support the clinical need for multi-level fusion.Pre-operative imaging should show evidence of the disease process, and post-operative imaging confirms the success of the fusion procedure.
The surgeon performs an anterior approach to the spine, removes a minimal amount of disc material to create space, and then performs the fusion of the additional vertebral interspace using bone graft material. The surgeon is responsible for all aspects of the surgery, including patient preparation, anesthesia, surgical technique, and post-operative care.
In simple words: This code is for an extra spinal fusion surgery performed on additional vertebrae in the spine after the surgeon has already performed a fusion surgery on one or more vertebrae.It's an added charge to the initial fusion, not a separate procedure.
This CPT code, 22585, represents an add-on code for each additional interspace requiring anterior interbody arthrodesis (spinal fusion) after a primary procedure (codes 22554-22558) has been performed.The procedure involves an anterior or anterolateral approach, minimal discectomy to prepare the interspace (excluding decompression), and arthrodesis. This code is only reported in addition to the primary procedure code (22554-22558).It is not used with 63075, even if performed by a different surgeon.For anterior cervical discectomy and interbody fusion at the same level during the same session, code 22552 is used instead.
Example 1: A patient presents with chronic back pain due to multilevel degenerative disc disease.The surgeon performs an anterior interbody fusion at L4-L5 (primary procedure, coded separately).An additional level (L5-S1) also requires fusion, so 22585 is added to the claim., A patient undergoes an anterior cervical discectomy and fusion (ACDF) at C5-C6. Intraoperatively, it is determined that C6-C7 also requires fusion due to instability.Code 22585 is added to bill for this additional level., During an anterior lumbar interbody fusion (ALIF) at L3-L4, the surgeon discovers that there is significant instability at L4-L5.The surgeon performs an additional ALIF at L4-L5, and 22585 is used to bill for this additional procedure.
* Operative report detailing the approach, discectomy (if performed), bone graft used, instrumentation (if any), and the specific levels fused.* Preoperative imaging (X-rays, CT, MRI) demonstrating the need for fusion.* Postoperative imaging to confirm fusion.* Anesthesia records.* Patient's medical history, including details of pain, prior treatment, and any comorbidities.
** Bone graft and instrumentation are reported separately.Always refer to the most current CPT guidelines and NCCI edits to ensure accurate coding and billing.The use of this code requires detailed documentation to support medical necessity.
- Revenue Code: P3D (Major Procedure, Orthopedic - Other)
- Payment Status: Active
- Modifier TC rule: Not applicable.This is an add-on code, therefore a technical component modifier is not necessary.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center