How To Use CPT Code 22103

CPT code 22103 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. 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 22103?

CPT 22103 is a code used to describe 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. This procedure involves removing a diseased or damaged area within a single bone of the neck or back.

2. Official Description

The official description of CPT code 22103 is: ‘Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment each additional segment (List separately in addition to code for primary procedure).’ This code should be used in conjunction with codes 22100, 22101, or 22102 for the primary procedure.

3. Procedure

During the procedure for CPT 22103, the healthcare provider makes an incision over the diseased bone in the neck or back. They then dissect down to the surface of the bone and strip the muscles from both sides of the spinous process and lamina. The provider uses surgical instruments to excise the diseased portion of the bone. After irrigating the wound, they close the incision in layers.

4. Qualifying circumstances

CPT 22103 is performed on patients who have an intrinsic bony lesion within a single vertebral segment. This procedure is typically used to treat conditions such as tumors, infections, or other abnormalities affecting the bone. It is important to note that CPT 22103 should only be reported for each additional vertebral segment excised after the first one.

5. When to use CPT code 22103

CPT code 22103 should be used when a healthcare provider performs a partial excision of the posterior vertebral component for an intrinsic bony lesion in a single vertebral segment. It is important to ensure that the procedure is performed on the appropriate vertebral segment and that the lesion meets the criteria for excision.

6. Documentation requirements

To support a claim for CPT 22103, the healthcare provider must document the following information:

• Patient’s diagnosis and the presence of an intrinsic bony lesion
• Specific vertebral segment(s) involved in the procedure
• Description of the excision performed, including the posterior vertebral component(s) removed
• Date of the procedure
• Any additional procedures performed in conjunction with CPT 22103
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 22103, ensure that the procedure meets the criteria for excision of the posterior vertebral component for an intrinsic bony lesion in a single vertebral segment. It is important to report this code in conjunction with the appropriate primary procedure codes (22100, 22101, or 22102). Additionally, follow any specific billing guidelines provided by the payer to ensure accurate reimbursement.

8. Historical information

CPT code 22103 was added to the Current Procedural Terminology system on January 1, 1996. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 22103

There are several similar codes to CPT 22103 that may be used in different scenarios. These include:

• CPT 22100: Excision of vertebral body, partial or complete, for intrinsic bony lesion, including discectomy, anterior approach with decompression of spinal cord and/or nerve root(s), thoracic
• CPT 22101: Excision of vertebral body, partial or complete, for intrinsic bony lesion, including discectomy, anterior approach with decompression of spinal cord and/or nerve root(s), lumbar
• CPT 22102: Excision of vertebral body, partial or complete, for intrinsic bony lesion, including discectomy, anterior approach with decompression of spinal cord and/or nerve root(s), cervical
• CPT 22104: Excision of posterior vertebral component, partial or complete, for intrinsic bony lesion, each additional vertebral segment (List separately in addition to code for primary procedure)
• CPT 22105: Excision of posterior vertebral component, partial or complete, for intrinsic bony lesion, thoracic

9. Examples

1. A patient with a tumor in the spinous process of a single vertebral segment undergoes a partial excision of the posterior vertebral component using CPT code 22103.
2. A healthcare provider performs a partial excision of the lamina for an intrinsic bony lesion in a single vertebral segment in a patient with an infection.
3. CPT code 22103 is used when a healthcare provider removes a portion of the facet joint for an intrinsic bony lesion in a single vertebral segment.
4. A patient with a diseased area within the spinous process of a single vertebral segment undergoes a partial excision using CPT code 22103.
5. A healthcare provider performs a partial excision of the posterior vertebral component for an intrinsic bony lesion in a single vertebral segment in a patient with a spinal abnormality.
6. CPT code 22103 is used when a healthcare provider removes a portion of the lamina for an intrinsic bony lesion in a single vertebral segment in a patient with a tumor.
7. A patient with an infection in the facet joint of a single vertebral segment undergoes a partial excision of the posterior vertebral component using CPT code 22103.
8. A healthcare provider performs a partial excision of the spinous process for an intrinsic bony lesion in a single vertebral segment in a patient with a spinal tumor.
9. CPT code 22103 is used when a healthcare provider removes a portion of the posterior vertebral component for an intrinsic bony lesion in a single vertebral segment in a patient with a spinal infection.