How To Use CPT Code 22226

CPT code 22226 describes the osteotomy of the spine, including discectomy, using an anterior approach. 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 22226?

CPT code 22226 is used to describe the osteotomy of the spine, specifically the removal of portions of the bone and the adjacent disk material, to correct an abnormal curvature in the neck or spine. This procedure is performed using an anterior approach and may involve the excision of a wedge-shaped piece of bone from the vertebral body at its midportion. CPT code 22226 is used for each additional vertebral segment that requires osteotomy and discectomy in addition to the primary procedure.

2. Official Description

The official description of CPT code 22226 is: ‘Osteotomy of spine, including discectomy, anterior approach, single vertebral segment each additional vertebral segment (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT codes 22220, 22222, and 22224 for the primary procedure.

3. Procedure

During the osteotomy of the spine using an anterior approach, the provider makes an incision in the vertebra to access the intervertebral disk space. Soft tissues are reflected subperiosteally from the adjacent vertebrae to expose the lamina and intervertebral disk space. The provider then uses bone cutting instruments to remove the adjacent disk material. A wedge-shaped piece of bone is excised from the vertebral body at its midportion. The procedure is then continued to realign the spine and the wound is closed.

4. Qualifying circumstances

CPT code 22226 is used for patients who require osteotomy of the spine and discectomy to correct an abnormal curvature in the neck or spine. This procedure is typically performed on patients with conditions such as scoliosis or kyphosis. The provider must perform the procedure using an anterior approach and must address each additional vertebral segment that requires osteotomy and discectomy in addition to the primary procedure.

5. When to use CPT code 22226

CPT code 22226 should be used when the provider performs an osteotomy of the spine, including discectomy, using an anterior approach. This code is used for each additional vertebral segment that requires osteotomy and discectomy in addition to the primary procedure. It is important to note that CPT code 22226 should only be used when the procedure is performed using an anterior approach and for each additional vertebral segment that requires osteotomy and discectomy.

6. Documentation requirements

To support a claim for CPT code 22226, the provider must document the following information:

• Patient’s diagnosis and the need for osteotomy of the spine and discectomy
• Specific details of the procedure performed, including the approach used
• Number of vertebral segments that required osteotomy and discectomy
• Date of the procedure
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 22226, ensure that the procedure meets the criteria for osteotomy of the spine and discectomy using an anterior approach. This code should be listed separately in addition to the code for the primary procedure (CPT codes 22220, 22222, or 22224). It is important to note that CPT code 22226 should not be reported if the procedure has already been performed in the previous seven days. Additionally, consider the location of the testing when coding for spinal osteotomy procedures, as they may have different coding requirements based on the setting.

8. Historical information

CPT code 22226 was added to the Current Procedural Terminology system on January 1, 1996. There have been several historical changes to the code, including code changes in 2007 and Medicare changes in 2017 and 2021.

9. Similar codes to CPT 22226

There are several similar codes to CPT code 22226 that are used to describe osteotomy procedures on the spine. These include:

• CPT 22220: Osteotomy of spine, including discectomy, anterior approach, single vertebral segment
• CPT 22222: Osteotomy of spine, including discectomy, anterior approach, 2-3 vertebral segments
• CPT 22224: Osteotomy of spine, including discectomy, anterior approach, 4 or more vertebral segments
• CPT 22225: Osteotomy of spine, including discectomy, posterior approach, single vertebral segment
• CPT 22227: Osteotomy of spine, including discectomy, posterior approach, 2-3 vertebral segments

9. Examples

1. A patient with severe scoliosis undergoes an osteotomy of the spine, including discectomy, using an anterior approach on two vertebral segments.
2. A patient with kyphosis requires an osteotomy of the spine, including discectomy, using an anterior approach on three vertebral segments.
3. A provider performs an osteotomy of the spine, including discectomy, using an anterior approach on a single vertebral segment to correct an abnormal curvature in a patient with spinal deformity.
4. An individual with a history of spinal trauma undergoes an osteotomy of the spine, including discectomy, using an anterior approach on four vertebral segments.
5. A patient with degenerative disc disease requires an osteotomy of the spine, including discectomy, using an anterior approach on two vertebral segments.
6. A provider performs an osteotomy of the spine, including discectomy, using an anterior approach on a single vertebral segment to correct an abnormal curvature in a patient with congenital spinal deformity.
7. An individual with spinal stenosis undergoes an osteotomy of the spine, including discectomy, using an anterior approach on three vertebral segments.