2025 CPT code 22899
(Active) Effective Date: N/A Surgery - Other Procedures on the Spine (Vertebral Column) Surgery Feed
Unlisted procedure, spine. This code is used for spinal procedures that don't have a specific CPT code.
Modifiers can be applied to 22899 as appropriate. Refer to current CPT guidelines.
Medical necessity must be clearly documented for any unlisted procedure. The documentation should explain why the procedure was necessary and why no existing CPT code accurately describes the service provided. The medical record should also support the medical necessity of the procedure.
The physician or other qualified healthcare professional performs a surgical procedure on the spine that is not described by a specific CPT code. This necessitates clear and detailed documentation to support the medical necessity of the procedure and to justify the billed amount.
In simple words: This code is used when a doctor does a surgery on your spine that doesn't have its own specific code. They’ll need to send extra paperwork to the insurance company explaining exactly what they did.
This code is used to report procedures performed on the spine (vertebral column) that are not described by other Category I CPT codes.It's essential to submit supporting documentation with the claim when using this code to clarify the exact nature of the procedure.
Example 1: A patient presents with a complex spinal fracture that does not fit the criteria for existing fracture repair codes. The surgeon performs a novel technique to stabilize the fracture. Code 22899 would be reported along with detailed documentation describing the procedure., A patient with a previous spinal fusion experiences a complication requiring a revision surgery. The specific nature of the revision is not adequately captured by other revision codes. Code 22899 is reported with operative notes explaining the revision performed., A surgeon performs a minimally invasive procedure to remove a spinal tumor using a new technique not described by existing codes. Code 22899 is reported along with documentation detailing the procedure and equipment used.
A detailed operative report outlining the specific procedure performed.Documentation supporting the medical necessity of the unlisted procedure.Comparison to similar, established CPT codes and an explanation of why those codes do not apply.If applicable, include details of any implants or devices used.
** It's strongly recommended to contact individual payers beforehand to confirm coverage policies for unlisted codes and any specific documentation requirements they may have. Be prepared to justify the medical necessity of the procedure, since unlisted codes are subject to increased scrutiny.
- Revenue Code: P3D - Major procedure, Orthopedic - Other
- Payment Status: Active