How To Use CPT Code 22114

CPT 22114 describes the partial excision of a vertebral body in the lumbar region for an intrinsic bony lesion, without decompression of the spinal cord or nerve root(s), involving 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 22114?

CPT 22114 is a code used to describe a surgical procedure that involves the partial excision of a vertebral body in the lumbar region. This procedure is performed to remove a damaged or diseased area contained within a single bone, without decompressing the spinal cord or nerve roots.

2. Official Description

The official description of CPT code 22114 is: ‘Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment lumbar.’

3. Procedure

During the procedure, the patient is appropriately prepped and anesthetized. The provider makes an incision in the lower back over the target vertebra and dissects down to the surface of the bone. The muscles are stripped from the vertebral body, and the damaged or diseased portion of the vertebral body is excised. The wound is irrigated, and the incision is closed in layers.

4. Qualifying circumstances

CPT 22114 is performed when there is an intrinsic bony lesion within a single vertebral segment in the lumbar region. This procedure does not involve decompression of the spinal cord or nerve roots. It is important to note that the specific circumstances and indications for this procedure should be determined by the healthcare professional based on the patient’s condition and medical history.

5. When to use CPT code 22114

CPT code 22114 should be used when a partial excision of a vertebral body is performed for an intrinsic bony lesion in the lumbar region, involving a single vertebral segment. It is important to ensure that the procedure does not involve decompression of the spinal cord or nerve roots, as this would require a different code.

6. Documentation requirements

To support a claim for CPT 22114, the healthcare professional must document the following information:

• Patient’s diagnosis and indication for the procedure
• Details of the procedure performed, including the specific vertebral segment and the extent of the excision
• Any additional procedures or interventions performed during the same operative session
• Any complications or unexpected findings
• Post-operative care instructions and follow-up plans
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 22114, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The procedure should involve the partial excision of a vertebral body for an intrinsic bony lesion in the lumbar region, without decompression of the spinal cord or nerve roots. It is also important to follow any additional billing guidelines provided by the payer or regulatory authorities.

8. Historical information

CPT code 22114 was added to the Current Procedural Terminology system on January 1, 1990. It has undergone changes in its status as an inpatient-only (IPO) procedure, being removed from the IPO list in 2021 and added back in 2022. It is important to stay updated with any changes or updates to the code to ensure accurate billing and coding practices.

9. Similar codes to CPT 22114

There are several similar codes to CPT 22114 that describe excision procedures on the spine (vertebral column). These include:

• CPT 22100: Excision of vertebral body for decompression, cervical
• CPT 22102: Excision of vertebral body for decompression, thoracic
• CPT 22103: Excision of vertebral body for decompression, lumbar
• CPT 22112: Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment cervical
• CPT 22113: Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment thoracic

9. Examples

1. A patient with a single vertebral segment lumbar lesion undergoes a partial excision of the vertebral body without decompression of the spinal cord or nerve roots.
2. A healthcare professional performs a partial excision of a vertebral body in the lumbar region for an intrinsic bony lesion, involving a single vertebral segment.
3. During a surgical procedure, a damaged area within a single lumbar vertebral segment is excised without decompressing the spinal cord or nerve roots.
4. A patient with an intrinsic bony lesion in the lumbar region undergoes a partial excision of the vertebral body without decompression of the spinal cord or nerve roots.
5. A healthcare professional performs a surgical procedure to remove a diseased area contained within a single lumbar vertebral segment, without decompressing the spinal cord or nerve roots.
6. During a surgical intervention, a damaged portion of a vertebral body in the lumbar region is excised without decompressing the spinal cord or nerve roots.
7. A patient with an intrinsic bony lesion in a single lumbar vertebral segment undergoes a partial excision of the vertebral body without decompression of the spinal cord or nerve roots.
8. A healthcare professional performs a surgical procedure to remove a damaged area within a single vertebral segment in the lumbar region, without decompressing the spinal cord or nerve roots.
9. During a surgical intervention, a diseased portion of a vertebral body in the lumbar region is excised without decompressing the spinal cord or nerve roots.
10. A patient with an intrinsic bony lesion in the lumbar region undergoes a partial excision of the vertebral body without decompression of the spinal cord or nerve roots.