2025 CPT code 22868
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Musculoskeletal System Surgery Feed
Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level.
Modifier 62 (two surgeons) may be appended if applicable.Modifier 51 (multiple procedures) may be appended to the primary procedure code if other procedures are performed during the same session.
The medical necessity for 22868 is established by the presence of clinically significant lumbar spinal stenosis causing neurological compromise or significant pain not relieved by conservative management.The need for multiple level decompression needs to be clearly documented.
The surgeon performs an open surgical approach to insert the device at an additional level, requiring dissection of tissues, muscle elevation, and preservation of the supraspinous ligament.Image guidance may be used for precise placement.Bone or ligament removal may be necessary.The device is secured, bleeding is controlled, tissues are closed, and a dressing is applied.
In simple words: The doctor inserts a device to help stabilize or open up space around the nerves in your lower back.This is done at a second location in your back during the same surgery as another similar procedure.The vertebrae aren't permanently joined.
This CPT code, 22868, represents the insertion of an additional interlaminar or interspinous process stabilization/distraction device at a second lumbar spine level.The procedure is performed during the same session as a primary procedure (22867) through an open approach.The device is attached to the spinous processes to restrict painful motion or open the neural foramina, relieving nerve root pressure, without fusion of the vertebrae. Image guidance may be utilized.This is an add-on code and must be reported with the primary procedure code.
Example 1: A patient presents with lumbar spinal stenosis at multiple levels.The surgeon performs 22867 at one level and 22868 at a second level during the same surgical session., A patient with degenerative disc disease undergoes a primary procedure (22867) at L4-L5.During the same procedure, the surgeon adds an additional level (L5-S1) and codes 22868., A patient with post-surgical spinal stenosis has a revision procedure. The surgeon uses 22867 for the main level and adds 22868 for an additional level requiring decompression.
** Some payers may consider this procedure investigational for certain indications. Always check payer-specific coverage policies before billing.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: This information is not available in the provided text.Refer to the CMS national fee schedule for current RVU data.
- Global Days: This information is not available in the provided text. Global period details vary based on payer and geographical location.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Fee schedule data is not available in the provided text. Refer to historical CMS data.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Office-based Surgery Center