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2025 CPT code 22870

Insertion of interlaminar/interspinous process stabilization/distraction device at additional lumbar levels.

This is an add-on code and must be reported in conjunction with 22869. Do not report with other definitive spine procedures at the same level.

Modifiers may apply based on specific circumstances, such as reduced services (52), discontinued procedure (53), or distinct procedural service (59).

Medical necessity must be established for each level treated. Documentation must support that conservative treatments have failed and that the patient's symptoms correlate with the level of device placement. Payer policies vary and pre-authorization might be required.

The physician performs the minimally invasive insertion, including prepping, anesthesia, incision, dissection, device placement, wound closure, and dressing.

IMPORTANT:(Use 22870 in conjunction with 22869) (Do not report 22869, 22870 in conjunction with 22532, 22533, 22534, 22558, 22612, 22614, 22630, 22632, 22633, 22634, 22800, 22802, 22804, 22840, 22841, 22842, 63005, 63012, 63017, 63030, 63035, 63042, 63044, 63047, 63048, 77003)

In simple words: This procedure involves inserting a small device between the bones in your lower back to help stabilize the spine or relieve pressure on nerves, without fusing the bones together. It's done through a small incision and may use imaging guidance.

Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (List separately in addition to code for primary procedure)

Example 1: A patient with lumbar spinal stenosis at two levels undergoes insertion of interspinous process distraction devices at both levels during the same session. 22869 would be reported for the first level and 22870 for the second level., A patient with lumbar instability at L4-L5 and L5-S1 undergoes placement of an interlaminar stabilization device. 22869 is reported for one level and 22870 is reported for the additional level., A patient previously had an interspinous distraction device placed at L4-L5. During a subsequent surgery, an additional device is placed at L3-L4. 22869 is reported for the new primary level and 22870 for the second level.

Documentation should include details of the patient's condition necessitating the procedure, the specific levels treated, type of device used, imaging guidance if performed, and operative details.

** Always verify payer coverage policies before performing and billing this procedure as some may consider it investigational for certain indications.

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