How To Use CPT Code 22207

CPT 22207 describes a specific procedure known as osteotomy of the spine, which involves making an incision in the vertebrae and removing a wedge of bone to correct an abnormal curvature in the lumbar spine. This article will provide a comprehensive overview of CPT code 22207, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 22207?

CPT 22207 is a code used to describe the procedure of osteotomy of the spine. This procedure involves making an incision in the vertebrae and removing a wedge of bone to correct an abnormal curvature in the lumbar spine. It is typically performed to address conditions such as scoliosis or other spinal deformities.

2. Official Description

The official description of CPT code 22207 is: ‘Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction) lumbar.’

3. Procedure

The procedure for CPT code 22207 involves several steps:

1. The patient is appropriately prepped and anesthetized.
2. An incision is made in the lower back, and the provider dissects through the fascia to expose the vertebra in question.
3. The lamina on the affected segment is excised, and a facetectomy is performed to expose and decompress the affected vertebrae.
4. The pedicle is resected, and bone wax is applied to the bony surfaces.
5. The nerve root is retracted while a wedge of the vertebral body is resected, and the procedure is repeated from the opposite side.
6. The provider then realigns the spinal deformity and assesses it with intraoperative imaging.
7. The area is irrigated, checked for bleeding, any instruments are removed, and the incision is closed.

4. Qualifying circumstances

CPT 22207 is typically performed on patients with an abnormal curvature in the lumbar spine, such as scoliosis or other spinal deformities. The procedure is performed using a posterior or posterolateral approach and involves the resection of three columns and one vertebral segment. It is important to note that CPT code 22207 should not be reported in conjunction with CPT code 22206.

5. When to use CPT code 22207

CPT code 22207 should be used when a provider performs an osteotomy of the spine using a posterior or posterolateral approach, resecting three columns and one vertebral segment in the lumbar region. It is important to ensure that the procedure aligns with the official description of the code and that it is not performed in conjunction with CPT code 22206.

6. Documentation requirements

To support a claim for CPT code 22207, the provider must document the following information:

• Patient’s diagnosis and the need for osteotomy of the spine
• Specific details of the procedure, including the approach used, the number of columns resected, and the vertebral segment involved
• Date of the procedure
• Any intraoperative imaging performed and the assessment of the spinal deformity
• Details of the closure of the incision and any post-procedure instructions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 22207, it is important to ensure that the procedure aligns with the official description and that it is not reported in conjunction with CPT code 22206. Providers should follow the appropriate coding guidelines and modifiers when reporting this code. It is also essential to review any specific billing guidelines provided by insurance payers to ensure accurate reimbursement.

8. Historical information

CPT code 22207 was added to the Current Procedural Terminology system on January 1, 2008. Since its addition, there have been several historical changes, including updates to the code description and its inclusion or exclusion from the Inpatient Only (IPO) list for Medicare reimbursement.

9. Similar codes to CPT 22207

While CPT code 22207 is unique in its description, there are other codes within the Osteotomy Procedures on the Spine (Vertebral Column) range that may be similar in nature. These codes include:

• CPT 22206: Osteotomy of spine, posterior or posterolateral approach, 2 columns, 1 vertebral segment (eg, wedge compression fracture) lumbar
• CPT 22208: Osteotomy of spine, posterior or posterolateral approach, 3 columns, 2 vertebral segments (eg, pedicle subtraction) lumbar
• CPT 22226: Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction) thoracic

9. Examples

1. A patient with severe scoliosis undergoes a posterior osteotomy of the lumbar spine (CPT 22207) to correct the abnormal curvature.
2. A provider performs a posterolateral osteotomy of the lumbar spine (CPT 22207) on a patient with a spinal deformity resulting from a wedge compression fracture.
3. An individual with a congenital spinal deformity undergoes a posterior osteotomy of the thoracic spine (CPT 22226) to correct the abnormal curvature.