2025 CPT code 22845
(Active) Effective Date: N/A Surgical Procedures on the Musculoskeletal System - Spine (Vertebral Column) Surgery Feed
Insertion of an anterior spinal fixation device across 2-3 vertebral segments to correct spinal deformity during spinal surgery.
Modifiers such as 22 (increased procedural services), 59 (distinct procedural service), 62 (two surgeons), 78 (unplanned return to OR), and XU (unusual non-overlapping service) may be applicable depending on the specific circumstances.Always verify payer-specific guidelines.
Medical necessity must be supported by documentation of spinal instability, deformity, or other conditions requiring surgical intervention and stabilization.
The surgeon prepares the patient, identifies the target vertebrae, creates a passage for screws, places the screws, avoids nerve and dura compression, secures the plate/rod/cable, may use hooks or cement, contours the rods, and closes the wound.
In simple words: The surgeon places hardware at the front of the spine across two or three bones in the back to stabilize it during a spinal surgery, like a fusion.
Anterior instrumentation (placement of spinal fixation device on the front of the spine) involving 2 to 3 vertebral segments. This code is reported separately in addition to the code for the primary procedure (e.g., spinal fusion or arthrodesis).
Example 1: A patient with spinal instability undergoes anterior lumbar interbody fusion (ALIF) at L4-L5 and L5-S1.Code 22845 is reported for the anterior instrumentation across these segments, along with the appropriate arthrodesis codes., A patient with scoliosis undergoes anterior spinal fusion from T10 to L1. The surgeon places anterior instrumentation across T10-T12 and 22845 is reported in addition to the fusion codes and other instrumentation if used., During an anterior corpectomy at L2 for burst fracture treatment, the surgeon inserts spinal instrumentation across two vertebral segments, reporting code 22845 in conjunction with the corpectomy and fusion codes.
Operative report should clearly document the approach (anterior), the type of instrumentation used, the number of vertebral segments involved (2-3), and the primary procedure performed.
** Ensure documentation clearly distinguishes between vertebral segments and interspaces.For instrumentation of 4-7 vertebral segments, use 22846; for 8 or more, use 22847. When billing with 22853, modifier XU may be necessary to indicate a distinct service if the instrumentation extends beyond what is included in 22853.
- Revenue Code: P3D - Major Procedure, Orthopedic - Other
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center