Do You Know When to Choose CPT® 2017 Lumbar Device Code 22867 Instead of 22869?

CPT 2017 lumbar stabilization device coding

In CPT® 2017, there are four new codes for insertion of lumbar stabilization and distraction devices. They replace two soon-to-be deleted Cat. III codes. So why did your options double? Here’s the answer to that question and more to help you ease in to 2017.

Swap Your Search for Distraction Device to Cat. I

2016 codes: In 2016, you had these lumbar stabilization codes in Category III of CPT®, but you now should add them to your 2017 deleted CPT® codes list:

  • 0171T, Insertion of posterior spinous process distraction device (including necessary removal of bone or ligament for insertion and imaging guidance), lumbar; single level
  • +0172T, … each additional level (List separately in addition to code for primary procedure).

2017 codes: As of Jan. 1, 2017, these services move on up to Category I as part of the CPT® updates. Here’s the list of CPT® code changes for 2017:

  • 22867, Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level
  • +22868, … second level (List separately in addition to code for primary procedure)
  • 22869, Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level
  • +22870, … second level (List separately in addition to code for primary procedure).

Get a Handle on What Makes Each Code Unique

Watch your combos: Code +22868 is an add-on code for primary code 22867, while +22870 is an add-on code for primary code 22869.

The construction of the new 2017 CPT® codes allows you to report one code per lumbar level.

Use 22867 (single level) and +22868 (second level) for services performed with open decompression, but without fusion.

Use 22869 (single level) and +22870 (second level) for services performed without open decompression or fusion.

Tip: Open decompression is the factor that differentiates your code choice, so watch for that in the documentation.

Heed CPT® 2017 Guidelines for When Codes Are NOT Allowed

Guidelines include a long list of codes you should not report in conjunction with the new codes.

The codes listed below are forbidden for both 22867/+22868 and 22869/+22870:

  • Arthrodesis codes 22532-+22534, 22558, 22612, +22614, 22630-+22634, 22800-22804
  • Spinal instrumentation codes +22840-+22842
  • Laminectomy codes 63005, 63012, 63017
  • Laminotomy codes 63030, +63035, 63042, +63044
  • Laminectomy, Facetectomy, and Foraminotomy codes 63047, +63048
  • Fluoroscopy code 77003.

Helpful hint: Fluoroscopy code 77003 isn’t the only guidance code to keep off your claim. The new code descriptors state that the services include imaging guidance when performed.

And don’t miss: Codes 22867 and +22868 have the added instruction that you should not report them in conjunction with 22869 and +22870.

Round Out Your Know-How With RVU Update

The 2017 Medicare Physician Fee Schedule (MPFS) Final Rule offers some insights into the valuation of these codes, just as it does for many of the 2017 CPT® code changes.

For example, here are the work RVUs you can expect these codes to have in the new year and how they compare to the recommendation from the AMA/Specialty Society Relative Value Update Committee (RUC):

  • 22867, 13.50 (lower than the RUC recommendation of 15.00)
  • +22868, 4.00 (same as the RUC recommendation)
  • 22869, 7.03 (lower than the RUC recommendation of 7.39)
  • +22870, 2.34 (same as the RUC recommendation).

How About You?

Did you use the Cat. III codes? Are you excited to have the new Cat. I options?

 

 

 

 

About 

Deborah concentrates on coding and compliance for radiology and cardiology, including the tricky world of interventional procedures, as well as oncology and hematology. Since joining The Coding Institute in 2004, she’s also covered the ins and outs of coding for orthopedics, audiology, skilled nursing facilities (SNFs), and more.

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1 Comments For This Post

  1. jitendra Says:

    really great article for medical coders like me….was looking for new cpt codes of 2017 and landed here…got to learn lot of things…!!!

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