ISASS Support for Coding of CORUS Spinal System and CAVUX FFS as Arthrodesis Technology

Approved by ISASS Board of Directors; August 26, 2023

Accurate coding for innovative technologies is essential to ensuring proper reimbursement and access for patients and healthcare providers.  The International Society for the Advancement of Spine Surgery (ISASS) Task Force on Coding and Reimbursement has reviewed the following proposal and fully endorses this course of action.

The CORUS Spinal System and CAVUX FFS, developed by Providence Medical Technology (PMT), represent significant advancements in the field of spinal fusion. These systems have been meticulously designed and have received clearance from the U.S. Food and Drug Administration (FDA) under product codes K212636 and K220951 respectively, with indications for use in posterior cervical fusion procedures. The product labeling clearly outlines their intended applications and capabilities, which align with the criteria for arthrodesis procedures.

The ISASS assessment of the CORUS Spinal System and CAVUX FFS, based on the information provided, suggests that the most appropriate Current Procedural Terminology (CPT) codes for billing purposes are 22600, Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment, with or without CPT code 22840, Posterior non-segmental instrumentation, one interspace. For each additional level, CPT codes 22614, Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure) and 22840, CPT code 22840, Posterior non-segmental instrumentation, one interspace. The reasons for the ISASS recommendation include:

1. Indications for Use: The CORUS Spinal System and CAVUX FFS are indicated for posterior cervical fusion procedures, which align with the description of CPT code 22600. (*See FDA labeling below)
2. Hardware Classification: The FDA product classification of CAVUX FFS as MRW (Facet Screw) corresponds directly to the hardware parenthetical described in CPT code 22840, supporting its inclusion in the coding structure.
3. Facet Fixation: While the CAVUX FFS involves an intrafacet component, it achieves facet fixation by spanning the interspace with points of fixation at both ends of the construct, a feature consistent with the intent of arthrodesis procedures.
4. Clinical Context: The CORUS Spinal System and CAVUX FFS are typically utilized in more complex fusion procedures, often in combination with anterior cervical discectomy and fusion (ACDF), which aligns with the scope of CPT code 22600.
5. Procedure Description: The intraservice work described in CPT code 22600, including approach, decortication, and fusion using bone graft material, more closely resembles the procedures involving the CORUS Spinal System and CAVUX FFS.

In conclusion, ISASS supports the use of CPT codes 22600 and 22840 for posterior cervical fusion procedures utilizing the CORUS Spinal System and CAVUX FFS. Accurate coding of these technologies is crucial to ensuring proper reimbursement and facilitating access to innovative treatments for patients.

Morgan Lorio MD, FACS

Chair, ISASS Task Force (Coding & Reimbursement)

MCRA

*FDA Labeling:

• The CORUS™ Spinal System is a set of instruments indicated to be used to perform posterior cervical fusion in patients with cervical degenerative disc disease.
• PMT Facet Fixation System (PMT or CAVUX FFS) is an integrated construct comprised of a CAVUX Cage and a single ALLY Bone Screw. PMT FFS is placed bilaterally through a posterior surgical approach and spans the interspace with points of fixation at each end of the construct. PMT FFS is intended for temporary stabilization as an adjunct to posterior fusion in skeletally mature patients. PMT FFS is indicated for patients requiring a revision for an anterior pseudarthrosis at one level, from C3 to C7, with autogenous and/or allogenic bone graft.