2025 CPT code 22612
(Active) Effective Date: N/A Revision Date: N/A Surgery - Arthrodesis Musculoskeletal System Feed
Posterior or posterolateral lumbar spine arthrodesis (spinal fusion) at a single interspace; with lateral transverse technique, when performed.
Modifiers 51 (multiple procedures) and 54 (surgical care only) may be applicable depending on the circumstances.
Medical necessity is established through clinical documentation demonstrating the presence of a specific spinal condition requiring surgical stabilization and fusion, such as degenerative disc disease, spondylolisthesis, or trauma.Persistent pain refractory to conservative management is also a necessary criterion.
The surgeon prepares the vertebral surfaces, applies bone graft, and may insert internal fixation devices.They are responsible for the entire surgical procedure, including incision, dissection, bone preparation, graft placement, fixation (if applicable), hemostasis, and closure.
In simple words: This code describes a spinal fusion surgery in the lower back.The doctor permanently joins two vertebrae (bones in your spine) using bone graft and may use metal implants. This is done to relieve back pain caused by problems like herniated discs or spinal stenosis.
This CPT code 22612 represents a surgical procedure involving posterior or posterolateral arthrodesis (spinal fusion) of a single interspace in the lumbar spine.The procedure may include the lateral transverse technique.It involves preparing the vertebral surfaces, applying bone graft material (which may be reported separately), and potentially using internal fixation devices (also separately reportable). The procedure aims to stabilize and fuse the vertebrae to alleviate pain and improve spinal stability.
Example 1: A patient presents with chronic low back pain due to degenerative disc disease at L4-L5.A posterior lumbar interbody fusion (PLIF) with bone graft is performed at L4-L5 using 22612. , A patient with spondylolisthesis at L5-S1 undergoes posterior lumbar fusion using 22612.Autologous bone graft is harvested and implanted.Pedicle screws are used for fixation and are reported separately., A patient with a burst fracture at L3-L4 requires posterior lumbar spine fusion with bone graft and instrumentation. 22612 is used along with codes for bone graft and instrumentation.
Preoperative imaging (X-rays, CT, MRI) showing the affected spinal segment(s), operative report detailing the surgical technique, including type and amount of bone graft used, type of internal fixation (if any), and postoperative imaging demonstrating fusion.
** Consider payer-specific guidelines for reporting bone graft harvesting and instrumentation separately.Always consult the most current CPT codebook and coding guidelines for accurate reporting.
- Revenue Code: P3D (Major Procedure, Orthopedic - Other)
- Payment Status: Active
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center