2025 CPT code 22614
(Active) Effective Date: N/A Revision Date: N/A Surgery - Arthrodesis Procedures on the Spine (Vertebral Column) Musculoskeletal System Feed
Arthrodesis, posterior or posterolateral technique, each additional interspace.
Modifiers 51 (multiple procedures), 59 (distinct procedural service), 76 (repeat procedure), and 62 (two surgeons) may be applicable based on the specific circumstances of the case.
Medical necessity is established based on clinical documentation supporting the need for spinal fusion. This usually includes evidence of pain, instability, neurologic compromise, and failure of conservative treatment options.Documentation must clearly show that the additional levels fused were medically necessary and directly related to the patient’s condition.
The surgeon is responsible for the surgical preparation, the fusion of the additional vertebrae, the application of bone graft, and closure.Anesthesiologist, surgical assistant, and other professionals may be involved but report their services separately.
- Musculoskeletal System
- Surgical Procedures on the Musculoskeletal System > Surgical Procedures on the Spine (Vertebral Column) > Arthrodesis Procedures on the Spine (Vertebral Column) > Posterior, Posterolateral or Lateral Transverse Process Technique Arthrodesis Procedures on the Spine (Vertebral Column)
In simple words: This code describes the extra work done to fuse additional bones in your spine beyond the initial fusion done during the same surgery.It's added to the main spinal fusion code and covers the preparation and fusion of each extra section of the spine.
This CPT code, 22614, represents an add-on code for spinal arthrodesis (fusion) using a posterior or posterolateral technique.It is reported in addition to the primary procedure code for arthrodesis at a single interspace and is used for each additional interspace fused during the same surgical encounter.The procedure involves preparing the vertebrae for fusion, potentially including decortication, and applying bone graft material.Metal implants may be used for stabilization, though these are typically reported separately. The code does not include decompression procedures.
Example 1: A patient undergoes L4-L5 spinal fusion (primary procedure, 22612), and during the same surgical session, the surgeon decides to fuse L5-S1, requiring the add-on code 22614. , A patient with multi-level spinal degeneration undergoes L2-L3 and L3-L4 fusion, along with a decompression procedure. The main fusion codes are reported for L2-L3 and L3-L4. Since additional levels are fused, add-on code 22614 would be reported for each fused level., Patient presents with instability of L4-L5, L5-S1. Surgeon performs L4-L5 fusion, uses bone graft and instrumentation. This would be coded as 22612 + 2284x (instrumentation)+ 2093x (bone graft) + 22614.
Surgical report detailing the procedure performed (including approach, levels fused, and materials used), operative notes, imaging studies (pre- and postoperative X-rays), anesthesia record, pathology reports if bone graft is from the patient, and medical necessity documentation.
** Always ensure proper documentation to support medical necessity and the performance of the additional interspace fusion.Consult with your coding specialist or billing department for accurate coding and billing practices.
- Revenue Code: P3D (Major Procedure, Orthopedic - Other)
- RVU: This information is not available in the provided source. Refer to the CMS national physician fee schedule for current relative value units (RVUs).
- Global Days: The global period for spinal fusion procedures varies based on the complexity of the surgery and the payer's policies.It's essential to refer to payer-specific guidelines and the CPT manual for details.
- Payment Status: Active
- Modifier TC rule: The Technical Component (TC) modifier does not apply to 22614.
- Fee Schedule: Historical fee schedule data is not provided. This information varies significantly by payer and location.Refer to the CMS national physician fee schedule and historical records for relevant fee data.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center