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2025 CPT code 22840

Posterior non-segmental instrumentation (e.g., Harrington rod technique, pedicle fixation across one interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation).

Report 22840 in addition to the primary procedure. Do not append modifier 62.

Modifiers may be applicable, including 22 (Increased Procedural Services), 50 (Bilateral Procedure), and 51 (Multiple Procedures), depending on the circumstances. Check with individual payers for specific modifier rules.

Medical necessity should be established by documenting the underlying condition requiring surgical intervention, the failure of conservative treatment, and the rationale for using this specific type of instrumentation.

The physician is responsible for proper patient positioning, surgical exposure, accurate placement of instrumentation using fluoroscopic guidance, and wound closure.

IMPORTANT:Use 22840 in conjunction with 22100-22102, 22110-22114, 22206, 22207, 22210-22214, 22220-22224, 22310-22327, 22532, 22533, 22548-22558, 22590-22612, 22630, 22633, 22634, 22800-22812, 63001-63030, 63040-63042, 63045-63047, 63050-63056, 63064, 63075, 63077, 63081, 63085, 63087, 63090, 63101, 63102, 63170-63290, 63300-63307. Do not append modifier 62 to spinal instrumentation code 22840.

In simple words: This procedure involves placing spinal hardware in the back of the neck to stabilize the spine, often during a spinal fusion. It involves attaching fixation devices without connecting to the bones in between the two endpoints of the device.

This code describes the insertion of posterior non-segmental spinal instrumentation, which involves fixation at each end of the construct without attachment to intervening segments. Examples include Harrington rod technique, pedicle fixation across one interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, and facet screw fixation.It is reported separately and in addition to the primary procedure (e.g., arthrodesis).

Example 1: A patient with atlantoaxial instability undergoes posterior C1-C2 transarticular screw fixation., A patient with a cervical fracture undergoes posterior pedicle fixation across one interspace., A patient with C1 instability undergoes sublaminar wiring.

Documentation should include the type of instrumentation used, the specific levels instrumented, the diagnosis necessitating the procedure, operative details, and any intraoperative complications.

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