How To Use CPT Code 22224

CPT 22224 describes the osteotomy of the spine, including discectomy, using an anterior approach on a single vertebral segment in the lumbar 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 22224?

CPT 22224 is used to describe a surgical procedure that involves the osteotomy of the spine, specifically in the lumbar region. During this procedure, a qualified healthcare provider makes an incision in the skin over the affected vertebra and removes portions of the bone to correct an abnormal curvature in the lower back. The procedure may also include the excision of the adjoining intervertebral disk material.

2. Official Description

The official description of CPT code 22224 is: ‘Osteotomy of spine, including discectomy, anterior approach, single vertebral segment lumbar.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The healthcare provider makes an incision 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 22224 is performed on patients with an abnormal curvature in the lumbar spine that requires correction through osteotomy. This procedure is typically indicated for conditions such as scoliosis or other spinal deformities. The patient must meet the criteria for surgical intervention and be under the care of a qualified healthcare provider.

5. When to use CPT code 22224

CPT code 22224 should be used when a qualified healthcare provider performs an osteotomy of a single vertebral segment in the lumbar spine, including discectomy, using an anterior approach. This code is appropriate for reporting the procedure when it is performed on a single vertebral segment. If additional segments are addressed, an add-on code, such as +22226, should be reported.

6. Documentation requirements

To support a claim for CPT 22224, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for osteotomy
• Specific details of the procedure performed, 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 provider performing the procedure

7. Billing guidelines

When billing for CPT 22224, ensure that the procedure meets the criteria for medical necessity and is performed by a qualified healthcare provider. It is important to follow the specific documentation requirements and guidelines set forth by the payer. Additionally, be aware of any bundling or unbundling issues and use the appropriate modifiers if necessary.

8. Historical information

CPT 22224 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, including updates to the description and its inclusion or exclusion from the Inpatient Only (IPO) list for Medicare reimbursement.

9. Examples

1. A patient with scoliosis undergoes an osteotomy of a single vertebral segment in the lumbar spine, including discectomy, using an anterior approach.
2. A healthcare provider performs an osteotomy of the lumbar spine, including discectomy, on a patient with a spinal deformity.
3. An individual with an abnormal curvature in the lower back undergoes an osteotomy of a single vertebral segment in the lumbar region to correct the alignment of the spine.
4. A qualified healthcare provider performs an osteotomy of the lumbar spine, including discectomy, on a patient with a congenital spinal abnormality.
5. A patient with a history of spinal trauma undergoes an osteotomy of a single vertebral segment in the lumbar spine to correct the resulting deformity.
6. An individual with a degenerative spinal condition undergoes an osteotomy of the lumbar spine, including discectomy, to alleviate symptoms and improve spinal alignment.
7. A healthcare provider performs an osteotomy of a single vertebral segment in the lumbar spine, including discectomy, on a patient with a progressive spinal disorder.
8. An individual with a spinal abnormality undergoes an osteotomy of the lumbar spine to improve their overall spinal alignment and function.
9. A patient with a history of failed conservative treatments for a spinal deformity undergoes an osteotomy of a single vertebral segment in the lumbar region to correct the curvature.
10. A qualified healthcare provider performs an osteotomy of the lumbar spine, including discectomy, on a patient with a severe spinal abnormality that is causing pain and functional limitations.