2025 CPT code 22590
Effective Date: N/A Surgery - Musculoskeletal System Feed
Arthrodesis, posterior technique, craniocervical (occiput-C2)
Modifiers can be applicable. Modifier 51 is used for multiple procedures, modifier 62 for two surgeons, modifier 22 for increased procedural services, and others as appropriate for specific circumstances.
Medical necessity must be established by documenting the underlying condition causing instability or pain, failed conservative treatment options, and the rationale for surgical intervention. This typically includes imaging studies (X-rays, CT, MRI) and clinical findings demonstrating the condition's severity.
The surgeon makes a midline incision from the external occipital protuberance to the spinous process of C2.After dissecting through the muscles and fascia, the cortical surfaces of the occipital bone, the posterior ring of the atlas (C1), and the spinous process and laminae of C2 are prepared. Bone graft material is placed, and the wound is closed in layers before an immobilization device is applied.
In simple words: The surgeon will perform a spinal fusion to permanently connect the base of your skull to your neck. They will use a bone graft to fuse the bones together from the back. This will help reduce neck pain caused by injuries or other back problems.
The provider performs arthrodesis, also known as spinal fusion, to permanently join the second cervical vertebra (C2) in the neck to the base of the cranium (occiput).A posterior approach is used, where bone graft material is applied to the back of the vertebrae to facilitate fusion. This procedure aims to alleviate persistent pain resulting from various spinal conditions such as herniated intervertebral discs, stenosis, or spinal injuries.
Example 1: A 50-year-old patient experiences chronic neck pain due to a herniated disc between C1 and C2.Posterior craniocervical fusion (22590) is performed to stabilize the joint and alleviate pain., Following a traumatic neck injury, a 30-year-old patient has instability between the occiput and C2.Code 22590 is used for the surgical fusion to restore stability., A 65-year-old patient with severe cervical stenosis at the craniocervical junction undergoes decompression and posterior fusion using code 22590 to address both the stenosis and instability.
Documentation should include the diagnosis, operative report detailing the surgical approach, type of bone graft used, any instrumentation or additional procedures performed, and the post-operative plan including immobilization.
- Revenue Code: P3D - Major Procedure, Orthopedic - Other
- Specialties:Neurosurgery, Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center