2025 CPT code 22586
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spine Musculoskeletal System Feed
Arthrodesis, presacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance; includes bone graft when performed, L5-S1 interspace.
Modifier 62 (two surgeons) may be appended if two surgeons perform distinct parts of the procedure.Modifier 51 (multiple procedures) may be used if this procedure is performed with other procedures. Other modifiers may apply depending on the specific circumstances.
Medical necessity for this procedure is established based on clinical findings (pain, neurological deficits, instability) and imaging studies showing degenerative disc disease, spondylolisthesis, or other pathology requiring spinal fusion.
The clinical responsibility includes the pre-operative planning and assessment of the patient, performing the surgical procedure (including incision, disc space preparation, discectomy, bone grafting, posterior instrumentation and closure), post-operative care, and follow-up.
In simple words: This code describes a spinal fusion surgery to permanently join two vertebrae in the lower back (L5-S1). The surgeon removes a damaged disc, prepares the space, and fuses the vertebrae using bone graft (if needed) and screws/rods.The surgery uses imaging guidance for precision.
This CPT code 22586 represents an arthrodesis procedure performed using a presacral interbody technique at the L5-S1 interspace.The procedure involves preparing the disc space, performing a discectomy, and implementing posterior spinal instrumentation with image guidance.Bone grafting is included when performed.This is a single-level procedure. Additional interspaces require separate coding.
Example 1: A 50-year-old male presents with chronic lower back pain due to degenerative disc disease at L5-S1.The patient is a candidate for spinal fusion.This code would be used to bill for the procedure., A 65-year-old female experienced a fracture of the L5 vertebra.Following reduction and stabilization, the surgeon recommends an arthrodesis of L5-S1 using this technique to provide additional stability.This code would be used., A 40-year-old male with a history of severe spondylolisthesis underwent an L5-S1 fusion using this technique, to stabilize the spine. This code would represent this procedure.
* Pre-operative imaging (X-ray, MRI, CT) demonstrating degenerative disc disease or other indication for surgery.* Operative report detailing the surgical technique and materials used (including bone graft if used).* Post-operative imaging to confirm fusion.* Patient's medical history, physical examination findings, and progress notes.
** This code is for a single-level fusion.Additional codes are required for multilevel fusions.The use of bone graft is included in the code; however, separate coding may be necessary if autologous bone is harvested through a separate incision.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: This information is not available in the provided text.Relative Value Units (RVUs) vary based on geographic location, facility type, and other factors.Consult the appropriate fee schedule for current values.
- Global Days: The global period for this procedure is not specified in the provided text. Consult the appropriate guidelines for determining the global period.
- Payment Status: Active
- Modifier TC rule: The provided text does not specify the application of a Technical Component (TC) modifier.
- Fee Schedule: Historical fee schedule data is not included in this text. Consult the appropriate fee schedules for historical information.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center