How To Use CPT Code 22214

CPT 22214 describes the procedure of osteotomy of the spine, specifically the posterior or posterolateral approach, involving one vertebral segment in the lumbar region. This article will provide a comprehensive overview of CPT code 22214, 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 22214?

CPT 22214 is used to describe the surgical procedure known as osteotomy of the spine. This procedure involves making a bony incision in the posterior or posterolateral region of one vertebral segment in the lumbar region. The purpose of this procedure is to realign the spine and correct spinal deformities.

2. Official Description

The official description of CPT code 22214 is: ‘Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment lumbar.’

3. Procedure

During the osteotomy procedure, the patient is appropriately prepped and anesthetized. The provider then makes an incision into the skin overlying the affected vertebra. Through this incision, the provider dissects down through the muscle and fascia to expose the spinous process and lamina of the central vertebra. The spinous process and lamina are then removed.

Next, the provider removes facets, pedicles, and lateral bone to protect the nerve roots. The provider also undercuts the laminae above and below to protect the dura and central neural elements, such as the spinal cord. After these steps, the provider realigns the spine to correct any deformities.

Once the realignment is complete, the provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

CPT code 22214 is used for patients who require an osteotomy of the spine to correct spinal deformities. This procedure is typically performed on patients with specific conditions or injuries that affect the lumbar region of the spine. It is important to note that the procedure must be performed by a qualified healthcare professional who is trained and experienced in performing osteotomies of the spine.

5. When to use CPT code 22214

CPT code 22214 should be used when a provider performs an osteotomy of one vertebral segment in the lumbar region using a posterior or posterolateral approach. It is important to ensure that the procedure performed aligns with the specific details outlined in the code description.

6. Documentation requirements

To support a claim for CPT code 22214, the healthcare professional must document the following information:

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

7. Billing guidelines

When billing for CPT code 22214, it is important to ensure that the procedure performed aligns with the specific details outlined in the code description. Additionally, it is crucial to follow any specific billing guidelines provided by the payer or insurance company.

It is also important to note that CPT code 22214 should not be reported with other codes that represent similar procedures, such as laminectomy, laminotomy, or diskectomy procedures performed at the same levels. The code is inclusive of decompression of the spinal cord, cauda equina, and single or multiple nerve roots.

8. Historical information

CPT code 22214 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been several historical changes to the code, 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 22214

There are several similar codes to CPT code 22214 that represent osteotomy procedures on the spine. These include:

• CPT 22216: Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment, each additional vertebral segment, list separately in addition to primary procedure.
• CPT 22206: Osteotomy of spine, anterior approach, 1 vertebral segment cervical.
• CPT 22208: Osteotomy of spine, anterior approach, 1 vertebral segment thoracic.
• CPT 22210: Osteotomy of spine, anterior approach, 1 vertebral segment lumbar.
• CPT 22212: Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment cervical.

9. Examples

1. A patient with severe scoliosis undergoes an osteotomy of the spine using a posterior approach to correct the spinal deformity.
2. An individual with a vertebral fracture in the lumbar region undergoes an osteotomy to realign the spine and stabilize the fractured vertebra.
3. A patient with a congenital spinal deformity undergoes an osteotomy to correct the abnormal curvature of the spine.
4. An individual with a degenerative disc disease in the lumbar region undergoes an osteotomy to relieve pressure on the affected nerves and improve spinal stability.
5. A patient with a spinal tumor undergoes an osteotomy to remove the tumor and restore spinal alignment.
6. An individual with a spinal infection undergoes an osteotomy to remove infected tissue and restore spinal stability.
7. A patient with a spinal injury undergoes an osteotomy to realign the spine and improve overall spinal function.
8. An individual with a spinal deformity resulting from a previous surgery undergoes an osteotomy to correct the deformity and improve spinal alignment.
9. A patient with a herniated disc in the lumbar region undergoes an osteotomy to remove the herniated portion of the disc and relieve pressure on the affected nerves.
10. An individual with a spinal stenosis in the lumbar region undergoes an osteotomy to decompress the spinal canal and relieve pressure on the spinal cord and nerves.