2025 CPT code 22844
(Active) Effective Date: N/A Surgery - Musculoskeletal System Feed
Posterior segmental instrumentation of the spine, spanning 13 or more vertebral segments.
Modifiers like 54 (Surgical care only), 55 (Postoperative management only), 76 (Repeat procedure or service by same physician), 77 (Repeat procedure by another physician), 78 (Return to the operating room for a related procedure during the postoperative period), and 79 (Unrelated procedure or service by the same physician during the postoperative period) may be applicable depending on the circumstances. Modifiers 22 (Increased procedural services) or 52 (Reduced services) might be applicable in unusual cases.
Medical necessity for this code must be supported by documentation of the underlying spinal condition requiring surgical intervention and the specific need for posterior segmental instrumentation across 13 or more levels to achieve the desired outcome (e.g., stabilization, deformity correction). The rationale for selecting this particular type of instrumentation should be clearly documented.
The surgeon exposes the posterior spine, prepares the bony structures, and inserts the instrumentation (e.g., pedicle screws, rods, hooks, wires) at multiple levels. Imaging guidance is often utilized. The instrumentation is secured to stabilize the spine.
In simple words: Placement of spinal instrumentation at the back of the spine, across 13 or more vertebrae, often used during spinal fusion to correct deformity.
Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires) involving 13 or more vertebral segments. This code is reported separately in addition to the code for the primary procedure.
Example 1: A patient with adolescent idiopathic scoliosis undergoes a T3-pelvis posterior spinal fusion, requiring segmental instrumentation spanning 13 or more vertebrae. Code 22844 is reported in addition to the fusion code., A patient with severe spinal trauma requires stabilization with posterior segmental instrumentation from T2 to L5. This involves 14 vertebral segments, hence 22844 is used along with the relevant trauma and fusion codes., A patient with a multi-level degenerative spinal condition undergoes a complex reconstruction procedure involving posterior segmental instrumentation across more than 12 vertebrae, combined with decompression and fusion. Code 22844 is reported along with the codes for the other procedures.
Documentation should clearly specify the type of instrumentation (e.g., pedicle screws, rods), the levels of the spine involved, the number of segments instrumented (13 or more), and the primary procedure performed. Operative reports with details of the surgical technique and imaging findings are essential.
** Ensure the documentation clearly differentiates between vertebral segments and interspaces. Segmental instrumentation implies fixation at each end of the construct and at least one additional point. Verify the documentation for accurate reporting. For any coding questions or specific payer guidelines, consult iFrameAI for the most up-to-date information.
- Modifier TC rule: Not applicable.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center