How To Use CPT Code 22222

CPT code 22222 describes the osteotomy of the spine, including discectomy, using an anterior approach on a single vertebral segment in the thoracic 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 22222?

CPT 22222 is used to describe the surgical procedure of osteotomy in the thoracic region of the spine. This procedure involves the removal of portions of the vertebra and adjacent disk material to correct an abnormal curvature in the upper back.

2. Official Description

The official description of CPT code 22222 is: ‘Osteotomy of spine, including discectomy, anterior approach, single vertebral segment thoracic.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. An incision is made in the skin overlying the affected vertebra.
3. The provider dissects down through the muscle and fascia to expose the lamina and intervertebral disk space.
4. Soft tissues are reflected subperiosteally from the adjacent vertebrae.
5. Bone cutting instruments are used to remove the adjacent disk material.
6. A wedge-shaped piece of bone is excised from the vertebral body at its midportion.
7. The provider realigns the spine.
8. The area is irrigated, checked for bleeding, and any instruments are removed.
9. The incision is closed.

4. Qualifying circumstances

CPT 22222 is performed on patients with an abnormal curvature in the thoracic spine that requires correction. The procedure is done using an anterior approach on a single vertebral segment in the thoracic region. It is important to note that decompression of the spinal cord, cauda equina, and/or single or multiple nerve roots is implied in osteotomies, and the codes for osteotomies are inclusive of these.

5. When to use CPT code 22222

CPT code 22222 should be used when performing an osteotomy of the spine, including discectomy, using an anterior approach on a single vertebral segment in the thoracic region. It is important to ensure that the procedure is performed on the appropriate region of the spine and using the specified approach.

6. Documentation requirements

To support a claim for CPT 22222, the following documentation is required:

• Patient’s diagnosis indicating the need for the osteotomy procedure
• Details of the procedure performed, including the specific vertebral segment and approach used
• Date of the procedure
• Any additional procedures or services performed during the same encounter
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 22222, ensure that the procedure is performed on a single vertebral segment in the thoracic region using an anterior approach. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, consider any applicable modifiers or additional codes that may be necessary to accurately report the procedure.

8. Historical information

CPT code 22222 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been several historical changes, including code updates and changes in Medicare coverage.

9. Examples

1. A patient with an abnormal curvature in the thoracic spine undergoes an osteotomy using an anterior approach on a single vertebral segment in the thoracic region (CPT 22222).
2. A surgeon performs an osteotomy of the spine, including discectomy, using an anterior approach on a single vertebral segment in the thoracic region to correct a patient’s abnormal curvature (CPT 22222).
3. During a surgical procedure, a provider performs an osteotomy of the spine in the thoracic region, including discectomy, using an anterior approach on a single vertebral segment (CPT 22222).
4. A patient with a thoracic spine abnormality undergoes an osteotomy procedure, including discectomy, using an anterior approach on a single vertebral segment (CPT 22222).
5. Using an anterior approach, a surgeon performs an osteotomy of the spine on a single vertebral segment in the thoracic region, including discectomy, to correct an abnormal curvature (CPT 22222).
6. A provider performs an osteotomy of the spine, including discectomy, using an anterior approach on a single vertebral segment in the thoracic region to correct a patient’s abnormal curvature (CPT 22222).
7. During a surgical procedure, a surgeon performs an osteotomy of the spine in the thoracic region, including discectomy, using an anterior approach on a single vertebral segment (CPT 22222).
8. A patient with a thoracic spine abnormality undergoes an osteotomy procedure, including discectomy, using an anterior approach on a single vertebral segment (CPT 22222).
9. Using an anterior approach, a provider performs an osteotomy of the spine on a single vertebral segment in the thoracic region, including discectomy, to correct an abnormal curvature (CPT 22222).
10. A surgeon performs an osteotomy of the spine, including discectomy, using an anterior approach on a single vertebral segment in the thoracic region to correct a patient’s abnormal curvature (CPT 22222).