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2025 CPT code 22837

Anterior thoracic vertebral body tethering for eight or more vertebral segments, including thoracoscopy if performed.

Refer to the official CPT manual for the most up-to-date coding guidelines.The number of vertebral segments tethered must be accurately documented.

Modifier 51 (multiple procedures) may be appended if 22837 is performed with other procedures. Modifier 62 (two surgeons) may be appended if applicable.

Medical necessity is established by the presence of significant scoliosis causing functional limitations or cosmetic concerns that do not respond to conservative management. The procedure should be supported by appropriate clinical documentation.

The surgeon accesses the anterior thoracic spine, inserts screws at each target vertebral level (eight or more), connects them with a cable, applies tension, and closes the incision. Post-operative care is included in the global period.

IMPORTANT:Do not report 22836, 22837 with 22845, 22846, 22847, 32601.For anterior lumbar or thoracolumbar vertebral body tethering (8 or more segments), use 0657T (Category III code).

In simple words: This procedure uses screws and a flexible cable to straighten a curved spine (scoliosis) in the upper or middle back.The cable is tightened to gently correct the curve while allowing the spine to continue growing. This is different from spinal fusion, which permanently joins the bones together.

This CPT code describes the surgical procedure of anterior thoracic vertebral body tethering involving eight or more vertebral segments.The procedure may include thoracoscopy.It is a technique used to correct spinal curvature, such as scoliosis, without the need for spinal fusion.Screws are placed in the anterior thoracic vertebrae, and a flexible cable (tether) connects these screws, applying tension to partially straighten the spine. This allows continued growth on the concave side while inhibiting growth on the convex side, leading to potential correction of scoliosis over time.

Example 1: A 14-year-old female with adolescent idiopathic scoliosis requiring correction of a thoracic curve involving 10 vertebral segments undergoes anterior thoracic vertebral body tethering using 22837., A 16-year-old male with severe scoliosis affecting the thoracic spine, involving 12 vertebral segments, undergoes the procedure using 22837. Thoracoscopy is utilized for improved visualization., A surgeon performs anterior thoracic vertebral body tethering on a 15-year-old patient, using a minimally invasive approach. This involves placing screws into 9 vertebral segments and connecting them with a flexible cable. This procedure would be coded 22837.

Preoperative imaging (X-rays, CT scans), operative report detailing the number of segments tethered, type of instrumentation used, and any complications. Postoperative imaging to assess the correction achieved.

** Thoracic vertebral body tethering is a relatively new surgical technique.Accurate documentation is crucial for appropriate coding and reimbursement.

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