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ISASS Policy Statement - cervical interbody.

Kern Singh1, Sheeraz Qureshi2

  • 1Minimally Invasive Spine Insitute, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.

International Journal of Spine Surgery
|February 20, 2015
PubMed
Summary
This summary is machine-generated.

This study addresses coding changes for cervical arthrodesis, focusing on CPT code 22551 and the use of allografts versus cages. It highlights insurer attempts to restrict spine surgeon choice and alter best practices.

Keywords:
policy

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Area of Science:

  • Spine surgery coding and reimbursement
  • Orthopedic surgical techniques

Background:

  • CPT code 22551 was revised in 2011, bundling previous codes for cervical arthrodesis.
  • Insurers have exerted downward pressure on CPT code 22551 since 2014, challenging cervical arthrodesis practices.
  • There is a division among spine surgeons regarding the use of allografts versus cages for cervical arthrodesis.

Purpose of the Study:

  • To analyze the impact of coding revisions on cervical arthrodesis procedures.
  • To examine insurer policies affecting the choice between allografts and cages.
  • To advocate for spine surgeon purview in cervical interbody fusion techniques.

Main Methods:

  • Review of Current Procedural Terminology (CPT) codes related to cervical fusion.
  • Analysis of reimbursement differences between structural allograft (CPT 20931) and cage use (CPT 22851).
  • Strategic identification of a consensus paper as an advocacy focus for ISASS/IASP.

Main Results:

  • CPT code 22551 bundles previous codes, impacting reimbursement for combined procedures.
  • CPT code 22851 (cage use) offers higher reimbursement per interspace than CPT 20931 (allograft use).
  • Some payers incorrectly deem spine cages as not medically necessary for cervical fusion.

Conclusions:

  • Coding and reimbursement policies can influence surgical choices and best practices in cervical arthrodesis.
  • The differing reimbursement rates for allografts and cages may contribute to payer disputes.
  • A consensus paper summarizing surgeon perspectives is crucial for advocating appropriate cervical interbody fusion techniques.