How To Use CPT Code 22614

CPT 22614 is an add-on code for arthrodesis procedures, specifically for each additional interspace during a posterior or posterolateral technique. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 22614 procedures.

1. What is CPT 22614?

CPT 22614 is an add-on code used in conjunction with primary arthrodesis codes to represent the fusion of each additional interspace during a posterior or posterolateral technique. This code is essential for medical coders and billers to accurately report and receive reimbursement for these additional interspaces during spinal fusion procedures.

2. 22614 CPT code description

The official description of CPT code 22614 is: “Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure)”.

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. Following arthrodesis of another interspace at the same session, the provider visualizes the affected vertebrae.
3. The provider dissects through the subcutaneous tissue and muscles to visualize the bone.
4. Muscles are stripped from the spinous process and posterior lamina out to the mid-portion of the facet joints.
5. Decortication is performed with bone cutting instruments.
6. Bone graft material is applied to the prepared bony surfaces of the vertebrae.
7. Metal implants may be inserted to hold the vertebrae together until new bone grows between them.
8. The provider sutures the muscles and ligaments over the grafted areas.
9. The area is irrigated, checked for bleeding, and instruments are removed.
10. The incision is closed, and a brace or immobilization device may be applied.

4. Qualifying circumstances

Patients eligible to receive CPT 22614 services are those undergoing spinal fusion procedures to alleviate persistent pain caused by various spinal conditions, including herniated intervertebral disks, stenosis, and spinal injuries. The code is used when the provider performs arthrodesis on each additional interspace at an encounter, following the fusion of another interspace at the same session.

5. When to use CPT code 22614

It is appropriate to bill the 22614 CPT code when the provider performs arthrodesis on each additional interspace during a posterior or posterolateral technique, following the fusion of another interspace at the same session. This code should be used in conjunction with primary arthrodesis codes, such as 22600, 22610, 22612, 22630, or 22633.

6. Documentation requirements

To support a claim for CPT 22614, the following information should be documented:

• Indication for the procedure, including the patient’s diagnosis and medical history.
• Details of the surgical procedure, including the approach, technique, and materials used.
• Number of additional interspaces fused during the procedure.
• Postoperative care instructions and follow-up plan.
• Any complications or adverse events encountered during the procedure.

7. Billing guidelines

When billing for CPT code 22614, it is essential to follow coding and payer guidelines to ensure proper reimbursement. This code is an add-on code and should be reported per interspace, in addition to the primary arthrodesis code. Check with payer guidelines to determine if graft harvesting can be reported separately for the specific case.

8. Historical information

CPT 22614 was added to the Current Procedural Terminology system on January 1, 1996. The code was changed on January 1, 2022, with the previous descriptor being “Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to code for primary procedure)”.

9. Similar codes to CPT 22614

Five similar codes to CPT 22614 and how they differentiate are:

1. CPT 22600: Arthrodesis of the cervical spine, posterior or posterolateral technique, single level.
2. CPT 22610: Arthrodesis of the thoracic spine, posterior or posterolateral technique, single level.
3. CPT 22612: Arthrodesis of the lumbar spine, posterior or posterolateral technique, single level.
4. CPT 22630: Arthrodesis of the lumbar spine, posterior interbody technique, single level.
5. CPT 22633: Combined arthrodesis of the lumbar spine, posterior or posterolateral technique with posterior interbody technique, single level.

10. Examples

Here are 10 detailed examples of CPT code 22614 procedures:

1. Arthrodesis of L4-L5 and L5-S1 interspaces using a posterior technique for a patient with degenerative disc disease.
2. Arthrodesis of C5-C6 and C6-C7 interspaces using a posterolateral technique for a patient with cervical spondylosis.
3. Arthrodesis of T10-T11 and T11-T12 interspaces using a posterior technique for a patient with thoracic spinal stenosis.
4. Arthrodesis of L3-L4, L4-L5, and L5-S1 interspaces using a posterolateral technique for a patient with lumbar spondylolisthesis.
5. Arthrodesis of C4-C5, C5-C6, and C6-C7 interspaces using a posterior technique for a patient with cervical myelopathy.
6. Arthrodesis of T8-T9 and T9-T10 interspaces using a posterolateral technique for a patient with thoracic disc herniation.
7. Arthrodesis of L2-L3 and L3-L4 interspaces using a posterior technique for a patient with lumbar spinal instability.
8. Arthrodesis of C3-C4 and C4-C5 interspaces using a posterolateral technique for a patient with cervical radiculopathy.
9. Arthrodesis of T6-T7 and T7-T8 interspaces using a posterior technique for a patient with thoracic vertebral fractures.
10. Arthrodesis of L1-L2, L2-L3, and L3-L4 interspaces using a posterolateral technique for a patient with lumbar degenerative scoliosis.