How To Use CPT Code 22101

CPT code 22101 describes the partial excision of the posterior vertebral component, such as the spinous process, lamina, or facet, for an intrinsic bony lesion in a single vertebral segment of the thoracic spine. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 22101?

CPT 22101 is a code used to describe the partial excision of the posterior vertebral component, specifically the spinous process, lamina, or facet, for the treatment of an intrinsic bony lesion in a single vertebral segment of the thoracic spine. This procedure involves removing a diseased area within the bone to alleviate symptoms and improve the patient’s condition.

2. Official Description

The official description of CPT code 22101 is: ‘Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment thoracic.’

3. Procedure

The procedure for CPT code 22101 involves the following steps:

1. The provider makes an incision over the diseased bone in the thoracic spine.
2. The provider dissects down to the surface of the bone.
3. The muscles from both sides of the spinous process and lamina are stripped.
4. The provider excises the diseased portion of the bone using surgical instruments.
5. The wound is irrigated and closed in layers.

4. Qualifying circumstances

CPT 22101 is used for patients who have an intrinsic bony lesion in a single vertebral segment of the thoracic spine. This code is specifically for the partial excision of the posterior vertebral component, such as the spinous process, lamina, or facet. It is important to note that CPT 22101 should only be reported for the removal of the posterior component and not the entire body of the vertebra.

5. When to use CPT code 22101

CPT code 22101 should be used when a provider performs a partial excision of the posterior vertebral component, such as the spinous process, lamina, or facet, for an intrinsic bony lesion in a single vertebral segment of the thoracic spine. It is important to accurately document the specific procedure performed to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 22101, the provider must document the following information:

• Patient’s diagnosis and the presence of an intrinsic bony lesion in a single vertebral segment of the thoracic spine
• Details of the procedure performed, including the specific posterior vertebral component excised (spinous process, lamina, or facet)
• Date of the procedure
• Incision site and approach used
• Any additional procedures or interventions performed during the same operative session
• Postoperative care instructions and follow-up plans

7. Billing guidelines

When billing for CPT 22101, it is important to ensure that the procedure performed meets the criteria outlined in the code description. Additionally, consider the following billing guidelines:

• Report CPT 22101 only for the partial excision of the posterior vertebral component (spinous process, lamina, or facet) and not for the entire body of the vertebra.
• Be aware that all hospital visits and post-discharge office visits related to this procedure, including evaluation of laboratory reports and medication adjustments, within 90 days after the operation are considered part of the postoperative work for CPT 22101.

8. Historical information

CPT code 22101 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 22101

There are several similar codes to CPT 22101 that may be used in different scenarios. These include:

• CPT 22100: Excision of vertebral segment, not otherwise specified
• CPT 22102: Excision of vertebral segment, each additional segment (List separately in addition to code for primary procedure)
• CPT 22103: Excision of vertebral segment, second through fifth segments (List separately in addition to code for primary procedure)
• CPT 22110: Excision of vertebral segment, sixth or more segments (List separately in addition to code for primary procedure)
• CPT 22112: Excision of vertebral segment, cervical

9. Examples

1. A patient undergoes a partial excision of the spinous process in the thoracic spine to remove a bony lesion.
2. A provider performs a partial excision of the lamina in a single vertebral segment of the thoracic spine to treat an intrinsic bony lesion.
3. An individual undergoes a partial excision of the facet in the thoracic spine to alleviate symptoms caused by an intrinsic bony lesion.
4. A patient with a bony lesion in a single vertebral segment of the thoracic spine undergoes a partial excision of the spinous process and lamina.
5. A provider performs a partial excision of the facet and lamina in the thoracic spine to remove an intrinsic bony lesion.
6. An individual undergoes a partial excision of the spinous process and facet in a single vertebral segment of the thoracic spine to treat a bony lesion.
7. A patient with an intrinsic bony lesion in the thoracic spine undergoes a partial excision of the spinous process and facet.
8. A provider performs a partial excision of the lamina and facet in a single vertebral segment of the thoracic spine to alleviate symptoms caused by a bony lesion.
9. An individual undergoes a partial excision of the spinous process, lamina, and facet in the thoracic spine to remove an intrinsic bony lesion.
10. A patient with a bony lesion in a single vertebral segment of the thoracic spine undergoes a partial excision of the spinous process, lamina, and facet.