2025 CPT code 22850
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spinal Instrumentation Procedures Musculoskeletal System Feed
Removal of posterior nonsegmental spinal instrumentation (e.g., Harrington rod).
Modifier 51 (multiple procedures) may be appended if other procedures are performed during the same session. Modifier 78 (unplanned return to OR) is appropriate if the removal is performed during the postoperative period due to a complication.
Removal of posterior nonsegmental spinal instrumentation is medically necessary when the device is causing pain, infection, or is malfunctioning.The removal may be necessary to prevent further neurological complications or to allow for the placement of new instrumentation.
The spine surgeon is responsible for the entire procedure, including incision, dissection, hardware removal, irrigation, hemostasis, and closure.Anesthesiologist and surgical nurses will also participate.
In simple words: The doctor removes old spinal hardware (like a Harrington rod) from the back because it's causing problems like pain or infection.They make a cut, take out the hardware, clean the area, and close the cut.
This surgical procedure involves the removal of previously implanted non-segmental spinal instrumentation, such as a Harrington rod, from the posterior spine.The procedure is indicated for pain, infection, rejection, or failure of the device. It includes incision, dissection to expose the instrumentation, removal of screws and fixation devices, irrigation with antibiotics, hemostasis, and closure of the incision.Appreciable vessel exploration or neuroplasty should be reported separately.
Example 1: A 60-year-old patient with a previously implanted Harrington rod experiences persistent back pain and localized infection.The surgeon performs a removal of the Harrington rod (22850)., A 55-year-old patient with a failed posterior nonsegmental spinal fixation device (due to mechanical failure) undergoes removal of the device (22850).The surgeon then inserts a new, more appropriate segmental device. Only the insertion codes (22840-22848) are reported in this scenario., A 70-year-old patient's Harrington rod is causing nerve compression. Removal of the rod (22850) is performed to relieve neurological symptoms.Additional codes might be necessary to address the nerve compression itself.
Preoperative imaging (X-rays, MRI) to assess the location and extent of the instrumentation; Operative report detailing the technique used for removal;Pathology report if any tissue samples are taken;Postoperative imaging to confirm complete removal;Documentation of the reason for removal (pain, infection, failure, etc.);Patient's history and symptoms.
** The term "nonsegmental" refers to fixation at each end of the construct without attachment to intervening segments.The greatest diameter of the instrumentation should be considered when determining the level of service.If the removal is part of a revision procedure with the placement of new instrumentation, only the insertion codes should be reported.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center