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2025 CPT code 22853

Insertion of interbody biomechanical device(s) with integral anterior instrumentation for device anchoring, during spinal interbody arthrodesis, per interspace.

Report one unit per interspace treated, regardless of the number of devices inserted at each level.Report this code only in conjunction with an appropriate primary procedure code for spinal interbody arthrodesis. Do not append modifier 62.

Modifiers such as 22 (increased procedural services), 59 (distinct procedural service), and XU (unusual non-overlapping service) may be appropriate in certain circumstances, with proper documentation.

Medical necessity is established by demonstrating degenerative disc disease, spinal instability, or other conditions causing pain and neurological compromise.Documentation should support the need for fusion and the use of interbody devices.

The surgeon exposes the intervertebral disc, retracts surrounding tissues, inserts the biomechanical device(s), secures it with the integral fixation, and completes the interbody arthrodesis.

IMPORTANT:Codes 22854 and 22859 are related codes for similar procedures but in different locations or without arthrodesis.If additional anterior instrumentation is used that is not integral to the device, codes 22845-22847 may be reported separately, with appropriate modifiers (e.g., modifier 59 or XU) to indicate distinct procedural services.

In simple words: This code covers placing a special device (like a cage or mesh) between two vertebrae during spinal fusion surgery. The device helps stabilize the spine, and it's attached using screws or other parts already on the device.The surgeon uses this procedure to treat back problems.

This CPT code reports the insertion of one or more interbody biomechanical devices (e.g., synthetic cage, mesh) into the intervertebral disc space.The devices must have integral anterior instrumentation (screws, flanges) for anchoring, and the procedure is performed in conjunction with interbody arthrodesis (spinal fusion).The code is reported separately, in addition to the primary procedure code, for each interspace treated.Additional anterior instrumentation not integral to the device should be coded separately.

Example 1: Anterior cervical discectomy and fusion (ACDF) at C5-C6 with insertion of a PEEK cage with integral screws., Anterior lumbar interbody fusion (ALIF) at L4-L5 with insertion of a titanium cage with integral flanges., Combined anterior and posterior spinal fusion with insertion of interbody devices at multiple levels (e.g.,L1-L5) requiring multiple units of 22853.Additional instrumentation codes may be needed depending on the specifics.

Detailed operative report specifying the type and number of devices used, location of insertion (interspaces), type of fixation (integral or additional), and any additional procedures performed (e.g., discectomy, corpectomy).Preoperative imaging (e.g., MRI, CT scan) demonstrating the need for the procedure.

** The use of PEEK cages or other specific interbody devices is encompassed by this code.Careful documentation is required to ensure appropriate reimbursement, particularly regarding the distinction between integral and non-integral instrumentation.

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