Position Statement On Insurance Coverage for Interbody Biomechanical Devices (CPT 22853) in Cervical Spine Arthrodesis
Background
Cervical spinal arthrodesis is a well-established surgical procedure used to treat degenerative cervical spondylotic myelopathy, radiculopathy, spinal instability, deformity, trauma, infection, and neoplastic conditions affecting the cervical spine. The goal is to achieve solid fusion between vertebral bodies following neural decompression and restoration of appropriate sagittal alignment.
For more than two decades, spine surgeons have successfully utilized interbody biomechanical devices — including polymer and metallic (e.g., titanium) cages to restore disc height, maintain alignment, and facilitate fusion.1-5 CPT® code 22853 appropriately captures the work involved with the insertion of these devices during spinal arthrodesis procedures.
Despite their widespread use and acceptance, payer policies continue to deny coverage for interbody spacers in routine anterior cervical discectomy and fusion (ACDF), characterizing them as experimental or not medically necessary relative to structural allograft alone.
This position is inconsistent with contemporary clinical practice and the consensus of leading spine societies, which recognize interbody devices as standard, evidence-based implants that enhance surgical outcomes and expand patient-specific treatment options.
Position Statement
Interbody biomechanical devices should be recognized as medically necessary and reimbursable for use in anterior cervical spinal fusion procedures.
Optimal patient care and patient safety are best achieved when surgeons and patients can jointly select from all clinically appropriate options — including structural autograft, allograft, and biomechanical devices — based on individual patient needs and preferences, and the recommendation of the treating surgeon.
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