2025 CPT code 22556
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spine Musculoskeletal System Feed
Arthrodesis of the thoracic spine using an anterior interbody technique, including minimal discectomy to prepare the interspace (excluding decompression).
Modifiers 22 (increased procedural services), 50 (bilateral procedure), 51 (multiple procedures), and 62 (two surgeons) may be applicable depending on the circumstances.Proper documentation is essential to support modifier use.
Medical necessity is established by documentation of chronic, intractable back pain related to disc herniation, spondylolisthesis, or other conditions causing spinal instability requiring surgical intervention.Pre-operative imaging should support the diagnosis.
The surgeon performs the anterior approach to the thoracic spine, removes a minimal amount of disc material to prepare the space for fusion, and then implants the bone graft (billed separately). The anesthesiologist, surgical assistants, and other support staff also have clinical responsibilities.
- Musculoskeletal System
- Anterior or Anterolateral Approach Technique Arthrodesis Procedures on the Spine (Vertebral Column)
In simple words: This code represents a spinal fusion surgery in the upper back (thoracic spine). The surgeon operates from the front of the body to fuse two vertebrae together, using a bone graft (billed separately) to help them heal.A small amount of damaged disc material may be removed to create space for the graft.
This CPT code, 22556, describes an anterior interbody arthrodesis (spinal fusion) of the thoracic spine.The procedure involves a minimal discectomy to prepare the intervertebral disc space for fusion.This is an anterior approach, meaning the surgeon accesses the spine from the front of the body. The code includes the surgical steps to prepare the interspace for fusion, but it does not include bone grafting or instrumentation, which are reported separately.Decompression procedures are not included in this code.
Example 1: A 45-year-old patient presents with chronic thoracic pain due to a herniated disc at T6-T7.The surgeon performs an anterior interbody fusion using a bone graft, and code 22556 is reported.Additional codes for bone graft and instrumentation would be reported if applicable., A 60-year-old patient with a history of trauma to the thoracic spine needs an anterior fusion of T4-T5.Code 22556 is reported for the fusion, with code 22585 added if more than one interspace is involved.Bone graft and instrumentation codes are used separately., A patient undergoing a corpectomy of T8 followed by arthrodesis of T7-T9 requires code 22556 for the arthrodesis. Because another definitive procedure was performed (corpectomy), modifier 51 is appended to the code for multiple procedures.Additional codes are necessary for the corpectomy, bone graft and instrumentation.
Detailed operative report specifying the approach (anterior), the levels fused, the minimal discectomy performed, type and amount of bone graft used (if applicable), and any instrumentation used (if applicable). Preoperative imaging (x-rays, CT, MRI) demonstrating the need for the procedure and postoperative imaging to confirm the fusion.
** This code is for a single interspace.For additional interspaces, code 22585 should be added separately.Always ensure appropriate documentation supports the medical necessity and the services performed.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: The relative value units (RVUs) for this code will vary depending on geographic location and payer.Consult the specific payer's fee schedule for the most current information.
- Global Days: The global period for this procedure varies depending on payer and specific circumstances. Consult the payer’s guidelines.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) modifier does not apply to this code, as it is for a complete surgical procedure.
- Fee Schedule: Historical fee schedule data will vary widely by location and payer.Consult payer-specific resources for relevant historical information.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center