2025 CPT code 22558
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spine Musculoskeletal System Feed
Anterior interbody arthrodesis of the lumbar spine, including minimal discectomy to prepare the interspace (other than for decompression).
Modifiers 51 (multiple procedures), 62 (two surgeons), and others may be applicable depending on the specific circumstances of the procedure.Consult payer guidelines.
The procedure is medically necessary to alleviate chronic lower back pain caused by degenerative disc disease, spondylolisthesis, or other conditions not responding to conservative treatment. Documentation should support the failure of non-surgical interventions.
The surgeon is responsible for the entire procedure, including the anterior approach, preparation of the interspace (including minimal discectomy), and placement of the bone graft.However, bone graft harvest and instrumentation are performed by the surgeon or another qualified professional, but billed separately.
In simple words: This code describes a surgery to fuse two vertebrae in the lower back to relieve pain. The surgeon makes an incision in the abdomen to reach the spine, removes some disc material, and inserts bone graft to fuse the vertebrae together permanently.
This CPT code encompasses the surgical procedure of anterior interbody arthrodesis (spinal fusion) in the lumbar spine.It involves a minimal discectomy to prepare the intervertebral space for fusion, excluding discectomies performed for decompression.The procedure includes the anterior or anterolateral approach, preparation of the interspace, and placement of bone graft material.It does not include the harvest of the bone graft or spinal instrumentation; these are reported separately.For additional interspaces, code 22585 is used. When two surgeons collaborate as primary surgeons, each performing distinct parts of the procedure, modifier 62 should be appended to the appropriate codes.For presacral interbody technique, use code 22586.
Example 1: A 55-year-old patient presents with chronic lower back pain due to degenerative disc disease at L4-L5. The surgeon performs an anterior interbody fusion (ALIF) at L4-L5 using 22558, harvesting autologous iliac crest bone graft (reported separately), and achieving successful fusion., A 60-year-old patient with spondylolisthesis at L5-S1 undergoes an anterior interbody fusion. The surgeon uses code 22558 for the fusion at L5-S1, with additional bone graft procedures (coded separately).A second surgeon assists with the approach and vessel retraction and uses modifier 62., A 48-year-old patient requires an ALIF at two levels (L3-L4 and L4-L5) due to multi-level degenerative disc disease. The surgeon utilizes 22558 for each level and reports 22585 for the additional interspace. The bone graft is harvested separately, and instrumentation is also reported separately.
Preoperative diagnosis, operative report detailing the approach, discectomy, bone graft placement, and closure; imaging studies (X-rays, CT, MRI) demonstrating the degenerative disc disease; pathology report if a biopsy was taken.
** Always refer to the most current CPT codebook and payer guidelines for the most up-to-date information on coding and reimbursement.
- Revenue Code: P3D (Major Procedure, Orthopedic - Other)
- RVU: This information is not available in the provided text.RVUs are determined by several factors including geographical location and payer.
- Global Days: The global period information is not specified in the provided text. Consult the payer's guidelines for details about the global surgical period.
- Payment Status: Active
- Modifier TC rule: The provided information does not specify if a Technical Component (TC) modifier applies.
- Fee Schedule: Historical fee schedule information is not available in the provided text.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center