2025 CPT code 22206
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spine Surgery Musculoskeletal System Feed
Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (e.g., pedicle/vertebral body subtraction); thoracic.
Modifiers 51 (multiple procedures), 62 (two surgeons) are applicable.
Medical necessity for this procedure would be established by the presence of significant symptomatic spinal deformity (e.g., kyphosis) causing pain, neurological compromise, or functional limitations. The severity of the deformity and the patient's response to conservative management should be documented.
The surgeon's responsibilities include preoperative assessment, surgical planning, performing the osteotomy, achieving spinal alignment correction, and postoperative care. This includes proper patient preparation, anesthesia administration, surgical technique (including laminectomy and facetectomy for exposure, pedicle and vertebral body resection, bone wax application), intraoperative imaging for assessment, wound irrigation, drain placement, and layered closure. The surgeon is responsible for appropriate documentation and follow up.
- Musculoskeletal System
- Musculoskeletal System > Surgical Procedures on the Musculoskeletal System > Spine Surgery
In simple words: The doctor removes parts of a bone in the upper back (thoracic vertebra) to correct a curved spine (kyphosis).This involves removing bone from the front, middle, and back of the vertebra. The procedure helps straighten the spine.
This CPT code, 22206, describes an osteotomy of the spine using a posterior or posterolateral approach, involving three columns (anterior, middle, and posterior) of a single thoracic vertebral segment.The procedure includes resection (subtraction) of portions of the pedicle and vertebral body.The surgical approach requires careful dissection to expose the vertebra, often including a laminectomy and facetectomy for better access and decompression. Bone wax may be used to seal bony surfaces.Intraoperative imaging is used to assess the correction of spinal deformity. The procedure concludes with irrigation, drainage placement, and layered closure of the incision.
Example 1: A 50-year-old female with severe thoracic kyphosis undergoes a posterior osteotomy of a single thoracic vertebra (T8) to correct the deformity. Code 22206 is reported., A 65-year-old male with a compression fracture of T6 and resulting kyphosis undergoes posterior spinal osteotomy (three-column resection) of T6, and instrumentation is performed using pedicle screws. Codes 22206 and 2284x (appropriate instrumentation code with modifier 51) are used., A 45-year-old female with significant thoracic kyphosis requires posterior osteotomy involving T7 and T8. Code 22206 is reported for T7, and code 22208 is added for T8.
Preoperative imaging (X-rays, CT scans), operative report detailing the surgical technique (including the three-column approach, specific bony resections, and instrumentation if any), intraoperative images showing correction of spinal deformity, and postoperative imaging.
** This procedure is typically performed for significant spinal deformity. Careful attention should be paid to the precise number of vertebral segments involved, which influences code selection.Adequate documentation is crucial to demonstrate medical necessity and justify reimbursement.The use of bone grafts or instrumentation should be reported with separate codes and appropriate modifiers.
- Payment Status: Active
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center