How To Use CPT Code 22212

CPT 22212 describes the procedure of osteotomy of the spine, specifically the posterior or posterolateral approach, involving one vertebral segment in the thoracic region. This article will provide a comprehensive overview of CPT code 22212, 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 22212?

CPT 22212 is a code used to describe the surgical procedure known as osteotomy of the spine. Specifically, it refers to the posterior or posterolateral approach performed on one vertebral segment in the thoracic region. This procedure involves making a bony incision to realign the spine and correct spinal deformities.

2. Official Description

The official description of CPT code 22212 is: ‘Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment thoracic.’

3. Procedure

During the osteotomy procedure, the patient is appropriately prepped and anesthetized. The surgeon begins by making an incision into the skin overlying the affected vertebra. They then dissect through the muscle and fascia to expose the spinous process and lamina of the central vertebra in question. The spinous process and lamina are removed to gain access to the affected area.

Next, the surgeon removes the facets, pedicles, and lateral bone to protect the nerve roots. They also undercut the laminae above and below to safeguard the dura and central neural elements, such as the spinal cord. Once the necessary bone removal and realignment of the spine are complete, the surgeon irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

CPT code 22212 is used for patients who require an osteotomy procedure to correct spinal deformities. This may include conditions such as scoliosis, kyphosis, or other abnormalities that affect the thoracic region of the spine. The procedure is performed by a qualified surgeon and involves the posterior or posterolateral approach on a single vertebral segment in the thoracic region.

5. When to use CPT code 22212

CPT code 22212 should be used when a surgeon performs an osteotomy of the spine using the posterior or posterolateral approach on one vertebral segment in the thoracic region. It is important to note that this code should not be reported for laminectomy, laminotomy, or diskectomy procedures at the same levels.

6. Documentation requirements

To support a claim for CPT code 22212, the surgeon 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 performing surgeon

7. Billing guidelines

When billing for CPT code 22212, ensure that the procedure meets the criteria outlined in the official description. It is important to follow the appropriate coding guidelines and modifiers, if applicable. Additionally, be aware of any specific billing requirements from insurance providers or government payers.

8. Historical information

CPT code 22212 was added to the Current Procedural Terminology system on January 1, 1990. 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 22212

There are several similar codes to CPT 22212 that describe different osteotomy procedures on the spine. These include:

• CPT 22206: Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment cervical
• CPT 22207: Osteotomy of spine, posterior or posterolateral approach, 2-3 vertebral segments cervical
• CPT 22208: Osteotomy of spine, posterior or posterolateral approach, 4-7 vertebral segments cervical
• CPT 22214: Osteotomy of spine, posterior or posterolateral approach, 2-3 vertebral segments thoracic
• CPT 22216: Osteotomy of spine, posterior or posterolateral approach, 4-7 vertebral segments thoracic

9. Examples

1. A patient with severe scoliosis undergoes a posterior osteotomy of the thoracic spine to correct the spinal curvature.
2. An individual with kyphosis requires a posterolateral osteotomy of a single vertebral segment in the thoracic region to address the abnormal spinal curvature.
3. A patient with a spinal deformity resulting from a previous injury undergoes a posterior approach osteotomy to realign the affected vertebral segment.
4. A surgeon performs a posterolateral osteotomy on a single vertebral segment in the thoracic spine to correct a congenital spinal abnormality in a pediatric patient.
5. An adult patient with a history of spinal fusion surgery requires a posterior osteotomy to address adjacent segment disease and restore proper spinal alignment.
6. A patient with a spinal tumor undergoes a posterior or posterolateral osteotomy to remove the affected vertebral segment and restore stability to the spine.
7. An elderly individual with degenerative disc disease and spinal stenosis undergoes a posterior osteotomy to relieve pressure on the spinal cord and nerve roots.
8. A patient with ankylosing spondylitis requires a posterolateral osteotomy to correct spinal deformities caused by the disease.
9. A young athlete with a sports-related spinal injury undergoes a posterior approach osteotomy to realign the affected vertebral segment and restore spinal stability.
10. A patient with a spinal infection requires a posterior or posterolateral osteotomy to remove the infected vertebral segment and promote healing.