2025 CPT code 22222
(Active) Effective Date: N/A Revision Date: N/A Surgery - Osteotomy Procedures on the Spine (Vertebral Column) Musculoskeletal System Feed
Anterior approach osteotomy of a single thoracic vertebral segment, including discectomy.
Modifiers 51, 62, 76, and 78 can be appended depending on the specifics of the surgical procedure. Refer to the CPT guidelines for detailed information on modifier use.
Medical necessity for this procedure is established by the presence of a significant spinal deformity causing pain, neurological compromise, or other functional limitations.The procedure should be considered medically necessary only after non-surgical interventions have failed to provide adequate relief.Documentation of failed conservative management is essential.
The orthopedic surgeon or spine specialist is responsible for all aspects of the procedure, including pre-operative planning, surgical technique, post-operative care, and any complications arising from the surgery. This includes making the incision, dissecting to expose the vertebra, performing the osteotomy and discectomy, realigning the spine, hemostasis, and wound closure.Post-operative management is also included within the global period, although this may be further modified based on the specific circumstances.
In simple words: The doctor cuts into a bone in the upper back (thoracic spine) to remove a small piece of bone and a disc to correct a spinal curve.
This CPT code encompasses the surgical procedure involving an anterior approach to perform an osteotomy (bone incision) on a single vertebral segment in the thoracic spine.The procedure includes a discectomy (excision of the intervertebral disc). This is typically done to correct spinal deformities or address specific pathologies affecting the thoracic vertebrae and intervertebral disc. The procedure involves incision, dissection through soft tissues, removal of the disc material, resection of a wedge-shaped portion of the vertebral body, realignment of the spine, irrigation, hemostasis, and closure.
Example 1: A patient presents with severe kyphosis (thoracic curvature) and associated pain.The surgeon performs an anterior osteotomy and discectomy at T6 to correct the curvature and alleviate the pain., A patient with a fracture-dislocation at T4 requiring correction undergoes an anterior osteotomy and discectomy to improve spinal alignment.Bone graft may be needed in addition to the osteotomy., A patient with a tumor impinging on the spinal cord in the thoracic region undergoes anterior osteotomy and discectomy to decompress the cord.This would typically involve additional codes for tumor resection.
Pre-operative imaging (X-rays, CT scans, MRI) demonstrating the spinal deformity or pathology.Operative report detailing the surgical approach, specific segments operated on, and the extent of bone and disc removal.Intraoperative images showing the correction achieved. Post-operative imaging showing the results of the surgical procedure.Patient's medical history and physical exam findings.
** This code should only be used for anterior approaches.Posterior approaches utilize different codes (e.g., 22212).The addition of bone grafting would require separate coding, as would any significant complications encountered during the procedure.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: The RVUs for this code vary based on geographic location, facility type, and other factors. Consult the Medicare Physician Fee Schedule (MPFS) and Local Coverage Determinations (LCDs) for the most accurate information.
- Global Days: The global period for this procedure varies depending on the specific circumstances of the surgery and the surgeon's judgment.There is no standard global period explicitly defined for this code.
- Payment Status: Active
- Modifier TC rule: No TC modifier is applicable to this code.
- Fee Schedule: Historical fee schedule information is not available in the source data but may be accessed through the Centers for Medicare & Medicaid Services (CMS) website or other relevant payer databases. Note that these fees are subject to constant change.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Hospital Outpatient