2025 CPT code 22841
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spinal instrumentation Musculoskeletal System Feed
Internal spinal fixation by wiring of spinous processes; add-on code.
Modifier 51 (multiple procedures) may be used if multiple procedures are performed.Modifier 62 should not be used. Other modifiers may apply depending on the specific circumstances of the case.
The medical necessity for this procedure is established by the underlying condition requiring spinal fusion or arthrodesis.The documentation should clearly link the need for internal spinal fixation (wiring) to the patient's clinical presentation, including symptoms, imaging findings, and failure of conservative treatment options.The specific type and placement of instrumentation should be justified based on the patient's anatomy and surgical goals.
The surgeon is responsible for all aspects of the procedure, including patient preparation, anesthesia, surgical technique (drilling, wiring, securing), and wound closure.The surgeon's responsibility extends to appropriate selection of instrumentation based on the surgical approach and vertebral segments involved. Post-operative care and follow-up are also the surgeon's responsibility.
- Musculoskeletal System
- This code is part of the larger category of spinal instrumentation codes within the CPT code set's Musculoskeletal System section. It's specifically an add-on code used with spinal fusion or arthrodesis procedures.
In simple words: The doctor uses wires to hold the bones of the spine together during a back surgery. This is done along with other steps of the surgery, such as fixing the spine.
This CPT code, 22841, reports internal spinal fixation achieved through wiring of the spinous processes.This is an add-on code, meaning it must be reported in conjunction with a primary procedure code representing the definitive spinal surgery (e.g., spinal fusion or arthrodesis). The procedure involves drilling holes at the base of the spinous processes, passing wires through these holes, and securing them using buttons, hooks, or clamps to achieve vertebral fixation. This procedure is performed as part of a larger spinal surgery.The selection of the specific instrumentation code depends on the surgical approach (anterior or posterior) and the vertebral segments involved.
Example 1: A patient undergoes posterior spinal fusion at L4-L5 for spondylolisthesis.The surgeon uses pedicle screws and spinal wiring (22841) to achieve fixation. 22841 is reported in addition to the primary fusion code., A patient with severe scoliosis requires a posterior spinal fusion from T10-L2. The surgeon utilizes rods, hooks, and wiring (22841) for internal fixation. Code 22841 is added to the primary fusion code(s)., A patient undergoes revision surgery for a failed spinal fusion.The surgeon removes the old instrumentation and inserts new rods and screws along with spinal wiring (22841) to achieve stable fixation.Only the new instrumentation code (22841 + primary procedure code) is reported.
The operative report should clearly document the specific spinal levels treated, the type of instrumentation used (wiring, buttons, hooks, clamps), and the primary procedure performed.Preoperative and postoperative imaging (X-rays, CT scans) should support the medical necessity and demonstrate the successful placement and fixation of the instrumentation.
** Accurate coding requires careful documentation specifying the surgical approach (anterior or posterior), the spinal levels involved, the type of instrumentation used, and the primary procedure performed.Understanding the difference between vertebral segments and interspaces is crucial for correct code selection.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: The RVUs for this code will vary based on the specific geographical location, payer, and other factors.It's important to consult the appropriate fee schedule for the precise RVU value.
- Global Days: The global period for this add-on code is determined by the global surgical package of the primary procedure it is appended to.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier does not typically apply to this code, as the service is considered an integral part of the primary procedure.
- Fee Schedule: Fee schedule data varies significantly by payer, location, and year.Refer to specific payer fee schedules for historical data.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center