KeyLift Interlaminar Decompression Review

Memo

Date: December 4th, 2025

To: All Providers, APPs, Clinical Staff, Scheduling, Billing & Coding

From: Medical Director & Coding Director

Subject: HCI Opinion - KeyLift Interlaminar Decompression Review

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Bottom Line

After internal clinical and coding review, HCI has determined that the KeyLift™ Interlaminar Stabilization System should be reported with an unlisted spine procedure code (CPT 22899).

The device does not meet the CPT intent of interspinous/interlaminar stabilization codes 22867–22870 nor the requirements of fusion/arthrodesis codes such as 22612.

As an unlisted procedure, reimbursement will be highly variable and not covered by Medicare in an ASC, subject to prior authorization, and at high risk for denial without extensive supporting documentation.

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Purpose of This Memo

Multiple clients have recently inquired about appropriate CPT coding for the KeyLift™ interlaminar decompression/stabilization procedure. To maintain uniform coding guidance and protect providers from reimbursement risk, HCI conducted an internal review of:

• FDA device classification and intended use

• Operative technique and device function

• CPT code family definitions

• Industry and payer interpretations

• Coding precedents for similar devices

This memo outlines our official internal position for use across all client accounts.

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Clinical & Technical Summary of the KeyLift™ Device

KeyLift™ is a supplemental fixation device—not a standalone stabilizer. Internal clinical review confirmed the following key points:

• KeyLift is a supplemental posterior fixation device

• It is not a standalone stabilizer and does not restrict flexion/extension

• It is not classified as an interspinous/interlaminar dynamic stabilization system

• It is designed for support in conjunction with graft material, not to achieve arthrodesis on its own

• It functions as a buttress rather than a motion-controlling implant

These characteristics place KeyLift outside the scope of existing CPT codes describing fusion, arthrodesis, decompression + stabilization, or dynamic interspinous fixation.

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Why Existing CPT Codes Do Not Apply

1. CPT 22612 (Posterior Lumbar Fusion)

Not appropriate because:

• No arthrodesis is created

• No decortication, grafting, or fusion technique is performed

• Device purpose does not meet fusion criteria

2. CPT 22867–22870 (Interlaminar/Interspinous Stabilization Devices)

Not appropriate because these codes require:

• A device intended to control spinal motion, and/or

• Dynamic stabilization or distraction characteristics

KeyLift does not perform these functions and does not hold the FDA classification required for these CPT codes.

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Coding Determination

Recommended CPT Code: 22899 – Unlisted Procedure; Spine

22899 is appropriate when a procedure:

• Involves posterior spinal instrumentation

• Does not create fusion

• Does not meet CPT definitions for decompression or stabilization codes

• Is not represented by any existing CPT descriptor

The KeyLift procedure fits all of these parameters, making 22899 the correct code for reporting.

— End of Memo —

HC Intellect is a Milwaukee-based healthcare revenue cycle management (RCM) and technology firm with a deep specialization in interventional pain management and related surgical specialties. The company partners closely with pain practices and ASCs to optimize coding, billing, and collections across the full revenue cycle, with particular expertise in complex procedure coding, E&M optimization, and payer-specific reimbursement challenges unique to interventional pain. By combining experienced RCM teams with proprietary analytics and AI-driven tools, HC Intellect helps pain practices reduce denials, accelerate cash flow, and sustainably improve financial performance.