How To Use CPT Code 22210

CPT 22210 describes the osteotomy of the spine, specifically the posterior or posterolateral approach, for one vertebral segment in the cervical region. 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 22210?

CPT 22210 is used to describe the surgical procedure known as osteotomy of the spine. This procedure involves making an incision into the vertebrae in the cervical region of the spine and removing a wedge of bone to correct an abnormal curvature in the neck area.

2. Official Description

The official description of CPT code 22210 is: ‘Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment cervical.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision into the skin overlying the affected vertebra.
3. The provider dissects down through the muscle and fascia to expose the spinous process and lamina of the vertebra.
4. The spinous process and lamina are removed.
5. The facets, pedicles, and lateral bone are removed to protect the nerve roots.
6. The provider undercuts the laminar surfaces above and below to protect the spinal cord.
7. The spine is manipulated into extension.
8. The area is irrigated, checked for bleeding, and any instruments are removed.
9. The incision is closed.

4. Qualifying circumstances

CPT 22210 is performed on patients who require correction of an abnormal curvature in the cervical spine. This procedure is typically performed by a qualified healthcare professional and is indicated when other conservative treatments have failed to provide relief. It is important to note that CPT 22210 is specific to the posterior or posterolateral approach for one vertebral segment in the cervical region.

5. When to use CPT code 22210

CPT code 22210 should be used when a provider performs an osteotomy of the spine using a posterior or posterolateral approach on one vertebral segment in the cervical region. It is important to select the appropriate code based on the location and approach of the procedure.

6. Documentation requirements

To support a claim for CPT 22210, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for the osteotomy procedure
• Specific details of the procedure, including the approach used and the vertebral segment involved
• Date of the procedure
• Any additional procedures performed during the same session
• Any complications or unexpected findings
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 22210, ensure that the procedure is performed using the posterior or posterolateral approach on one vertebral segment in the cervical region. It is important to follow the specific guidelines for reporting additional vertebral segments if applicable. It is also important to consider any Medicare changes or updates that may affect billing for this procedure.

8. Historical information

CPT 22210 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, including being added and removed from the Inpatient Only (IPO) list for Medicare. It is important to stay updated on any changes or updates to ensure accurate billing.

9. Examples

1. A patient with cervical kyphosis undergoes a posterior osteotomy of one vertebral segment in the cervical region to correct the abnormal curvature.
2. A patient with cervical scoliosis undergoes a posterolateral osteotomy of one vertebral segment in the cervical region to correct the abnormal curvature.
3. A patient with cervical lordosis undergoes a posterior osteotomy of one vertebral segment in the cervical region to correct the abnormal curvature.
4. A patient with cervical stenosis undergoes a posterolateral osteotomy of one vertebral segment in the cervical region to relieve pressure on the spinal cord.
5. A patient with cervical spondylosis undergoes a posterior osteotomy of one vertebral segment in the cervical region to alleviate symptoms and improve mobility.
6. A patient with cervical disc herniation undergoes a posterolateral osteotomy of one vertebral segment in the cervical region to decompress the affected nerve roots.
7. A patient with cervical radiculopathy undergoes a posterior osteotomy of one vertebral segment in the cervical region to relieve nerve compression and alleviate symptoms.
8. A patient with cervical myelopathy undergoes a posterolateral osteotomy of one vertebral segment in the cervical region to decompress the spinal cord and improve function.
9. A patient with cervical instability undergoes a posterior osteotomy of one vertebral segment in the cervical region to stabilize the spine and prevent further damage.
10. A patient with cervical disc degeneration undergoes a posterolateral osteotomy of one vertebral segment in the cervical region to remove the affected disc and restore spinal alignment.