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Official Description

Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Arthrodesis, specifically the anterior interbody technique, is a surgical procedure aimed at achieving spinal fusion by immobilizing a joint in the cervical region below C2. This technique involves the removal of intervertebral discs and preparation of the interspace to facilitate the fusion of adjacent vertebrae. The procedure is typically indicated for conditions such as herniated discs, lesions, and stabilization of fractures or dislocations of the spine. By inducing the bones to grow solidly together, the surgery aims to alleviate pain and restore stability to the affected area of the spine. The approach is made from the front (ventral) side of the neck, allowing for direct access to the vertebrae while carefully avoiding critical structures such as the esophagus, trachea, and thyroid gland. The use of traction on the head during the procedure helps maintain proper alignment and positioning of the vertebrae, ensuring that the surgical site is adequately prepared for the placement of a bone graft, which is essential for successful fusion.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Arthrodesis using the anterior interbody technique is performed for specific medical conditions and symptoms that necessitate spinal stabilization and fusion. The following indications are explicitly recognized for this procedure:

  • Herniated Discs - This condition occurs when the inner gel-like core of a spinal disc protrudes through a tear in the outer layer, potentially causing pain, numbness, or weakness.
  • Lesions - Abnormal tissue growths or damage in the spinal area that may require surgical intervention to restore function and alleviate discomfort.
  • Stabilization of Fractures - Fractures in the cervical spine that compromise stability and require surgical fusion to prevent further injury or complications.
  • Dislocations of the Spine - Displacement of vertebrae that can lead to instability and necessitate surgical correction and fusion to restore alignment and function.

2. Procedure

The anterior interbody arthrodesis procedure involves several critical steps to ensure successful spinal fusion. Each step is designed to prepare the intervertebral space and facilitate the placement of a bone graft.

  • Step 1: Patient Positioning - The patient is positioned appropriately, typically lying on their back, with traction applied to the head to maintain alignment of the cervical spine during the procedure.
  • Step 2: Surgical Access - An incision is made in the neck, carefully avoiding vital structures such as the esophagus, trachea, and thyroid gland. This approach allows the surgeon to access the affected vertebrae from the front (ventral) side.
  • Step 3: Muscle Retraction - An instrument is utilized to hold the intervertebral muscles apart, providing a clear view and access to the vertebrae that need to be treated.
  • Step 4: Vertebral Preparation - A drill is inserted into the afflicted vertebrae, with its positioning confirmed via X-ray imaging. This step is crucial for ensuring accurate placement and preparation of the vertebrae.
  • Step 5: Creating the Interspace - The drill or saw is used to cut a groove or channel in the front of the vertebrae, allowing for the removal of the damaged disc material.
  • Step 6: Cleaning the Interspace - Spring-loaded forceps equipped with a sharp blade are employed to clean out the area between the two adjacent vertebrae, removing any remaining cartilage and preparing the site for the bone graft.
  • Step 7: Bone Graft Placement - Bone is procured either from a donor or from the patient's hip area. The graft is then packed into the cleaned-out space, trimmed to fit, and positioned to promote fusion.
  • Step 8: Closure - The traction on the head is gradually reduced to ensure the bone graft remains in place. The fibrous membranes covering the deep vertebral area are sutured, a drain may be placed if necessary, and the incision is sutured closed.

3. Post-Procedure

After the anterior interbody arthrodesis procedure, patients can expect a recovery period that may involve monitoring for complications and managing pain. Post-operative care typically includes instructions for activity restrictions, pain management strategies, and follow-up appointments to assess healing and fusion progress. Physical therapy may be recommended to aid in recovery and restore mobility. Patients should be aware of signs of infection or other complications and report any concerns to their healthcare provider promptly.

Short Descr ARTHRD ANT NTRBD MIN DSC CRV
Medium Descr ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2
Long Descr Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 158 - Spinal fusion

This is a primary code that can be used with these additional add-on codes.

20705 Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure)
20930 Addon Code MPFS Status: Bundled Code APC N ASC N1 CPT Assistant Article Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)
20931 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)
20936 Addon Code MPFS Status: Bundled Code APC N ASC N1 CPT Assistant Article Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)
20937 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (List separately in addition to code for primary procedure)
20938 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (List separately in addition to code for primary procedure)
20939 Addon Code MPFS Status: Active Code APC N ASC N1 Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure)
22585 Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)
22840 Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure)
22841 Addon Code MPFS Status: Bundled Code APC C Physician Quality Reporting CPT Assistant Article Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure)
22842 Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)
22843 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)
22844 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for primary procedure)
22845 Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
22846 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)
22847 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure)
22848 Addon Code MPFS Status: Active Code APC N Physician Quality Reporting CPT Assistant Article Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure)
22853 CPT Add On MPFS Status: Active Code APC N ASC N1 Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)
22854 CPT Add On MPFS Status: Active Code APC N ASC N1 Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
22859 CPT Add On CPT Resequenced MPFS Status: Active Code APC N ASC N1 Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
GC This service has been performed in part by a resident under the direction of a teaching physician
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
SG Ambulatory surgical center (asc) facility service
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2022-01-01 Note Short and Medium description changed.
2013-01-01 Note Guideline information changed.
2011-01-01 Note Medium description changed. Guideline information changed.
2007-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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