How To Use CPT Code 22102

CPT 22102 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 lumbar 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 22102?

CPT 22102 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 lumbar spine. This procedure involves the removal of a diseased area within the bone to alleviate symptoms and improve the patient’s condition.

2. Official Description

The official description of CPT code 22102 is: ‘Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment lumbar.’

3. Procedure

The procedure for CPT 22102 involves several steps:

1. The provider makes an incision over the diseased bone in the lower back.
2. He 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 then excises the diseased portion of the bone using surgical instruments.
5. The wound is irrigated, and the incision is closed in layers.

4. Qualifying circumstances

CPT 22102 is performed on patients who have an intrinsic bony lesion in a single vertebral segment of the lumbar spine. This procedure 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 22102 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 22102

CPT code 22102 should be used when a partial excision of the posterior vertebral component is performed for an intrinsic bony lesion in a single vertebral segment of the lumbar spine. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 22102, the following documentation is required:

• Patient’s diagnosis and the presence of an intrinsic bony lesion in a single vertebral segment of the lumbar 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 performed during the same operative session
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 22102, it is important to ensure that the procedure meets the specific criteria outlined in the code description. Additionally, consider the following billing guidelines:

• Report CPT 22102 only for the partial excision of the posterior vertebral component (spinous process, lamina, or facet) and not for the entire body of the vertebra.
• Do not report CPT 22102 if the procedure involves the insertion of posterior spinous process distraction devices. In such cases, refer to the appropriate codes (22867, 22868, 22869, 22870).
• Consider the location of the testing when coding for pulmonary function tests (PFTs) as they have both a professional and technical component.

8. Historical information

CPT 22102 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. Examples

Here are some examples of cases where CPT code 22102 may be used:

1. A patient with a bony lesion in a single vertebral segment of the lumbar spine undergoes a partial excision of the spinous process to alleviate symptoms.
2. A provider performs a partial excision of the lamina in a patient with an intrinsic bony lesion in a single vertebral segment of the lumbar spine.
3. A patient with a facet bony lesion in a single vertebral segment of the lumbar spine undergoes a partial excision of the facet to improve their condition.
4. A provider performs a partial excision of the spinous process and lamina in a patient with an intrinsic bony lesion in a single vertebral segment of the lumbar spine.
5. A patient with a bony lesion in a single vertebral segment of the lumbar spine undergoes a partial excision of the facet and lamina to alleviate symptoms.