2025 CPT code 22847
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spinal instrumentation procedures Musculoskeletal System Feed
Anterior spinal instrumentation; 8 or more vertebral segments. This is an add-on code requiring a primary procedure code.
Modifier 51 (multiple procedures) is applicable when reporting this code with other definitive procedures.Modifier 62 (two surgeons) is applicable if two surgeons perform distinct parts of the procedure.Other modifiers may apply depending on the specific circumstances, such as modifier 78 for unplanned return to the OR.
Medical necessity for 22847 is established by the presence of a spinal deformity or instability requiring surgical correction.Documentation should clearly demonstrate the severity of the condition, the failure of conservative treatments, and the expected benefits of surgical intervention.
The surgeon is responsible for all aspects of the procedure, including patient preparation and anesthesia, identifying the target vertebral segments, preparing the bone for screw placement, inserting screws, securing the instrumentation, and integrating the instrumentation with the primary procedure.The surgeon must ensure the safety of the spinal cord and nerves during the procedure.
In simple words: The doctor puts in metal supports to the front of the spine across eight or more bones to straighten a curved spine during a back surgery, like spinal fusion.
This CPT code, 22847, represents the anterior placement of spinal instrumentation spanning eight or more vertebral segments.It's an add-on code, meaning it must be reported in conjunction with a primary procedure code (e.g., spinal fusion, arthrodesis) reflecting the main surgical intervention. The procedure involves securing a fixation device (plate, rod, cable, etc.) to the anterior aspect of the spine using screws, hooks, or cement (methyl methacrylate) to correct spinal deformity. The code encompasses the surgical steps of preparing the passageway for screws, inserting screws into the vertebral bodies (avoiding damage to the dura and spinal nerves), attaching the device, contouring the rods, and integrating the instrumentation with the primary procedure.It should not be used with codes 22836, 22837, or 22838 (vertebral body tethering).
Example 1: A patient with severe scoliosis undergoes posterior spinal fusion with anterior instrumentation (22847) to correct the curvature.The anterior instrumentation provides additional stabilization and support for the fusion., A patient with a burst fracture of multiple vertebrae requires anterior corpectomy, followed by anterior spinal fusion with instrumentation (22847) for stabilization and to restore spinal alignment., A patient with spinal stenosis and instability undergoes a complex multilevel anterior approach with discectomy, fusion, and anterior instrumentation (22847) to decompress the spinal cord and stabilize the spine.
** This code should only be reported when anterior instrumentation spans eight or more vertebral segments. Ensure accurate documentation and proper use with a primary procedure code.
- Revenue Code: P3D
- RVU: The RVUs for this code will vary depending on the specific circumstances of the procedure (e.g., geographic location, facility type). Consult a relevant fee schedule for specific RVU values and reimbursement details.
- Global Days: The global period for this procedure will vary based on the primary procedure and other factors.Consult the specific CPT guidelines and payer policies for details on the global period and any potential implications for billing additional services.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Historical fee schedule data for this code would need to be accessed from specific payer-specific fee schedules or other relevant databases.These data will vary by year, payer, geographic location, and other factors.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital