How To Use CPT Code 22325

CPT code 22325 describes the open treatment and/or reduction of a vertebral fracture or dislocation using a posterior 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 22325?

CPT 22325 is used to describe the open treatment and/or reduction of a vertebral fracture or dislocation using a posterior approach. This code is specifically for the treatment of one fractured vertebra or dislocated segment in the lumbar region of the spine.

2. Official Description

The official description of CPT code 22325 is: ‘Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment lumbar.’

3. Procedure

During the procedure for CPT 22325, the healthcare provider begins by making an incision over the affected vertebra in the lumbar spine. They then dissect through the fascia and muscle to visualize the fractured or dislocated segment. The provider resects the bone to protect the neural tissue and proceeds to reduce the fracture or dislocation using surgical tools. In some cases, spinal instrumentation, such as rods and hooks, may be applied to secure alignment. The area is irrigated, bleeding is checked, instruments are removed, and the incision is closed.

4. Qualifying circumstances

CPT 22325 is used for patients who have a vertebral fracture or dislocation in the lumbar region of the spine that requires open treatment and/or reduction. It is important to note that CPT 22325 should not be reported in conjunction with codes 22511, 22512, 22514, or 22515 when performed at the same level.

5. When to use CPT code 22325

CPT code 22325 should be used when a healthcare provider performs open treatment and/or reduction of a vertebral fracture or dislocation in the lumbar region of the spine using a posterior approach. It is important to ensure that the procedure is performed on one fractured vertebra or dislocated segment.

6. Documentation requirements

To support a claim for CPT 22325, the healthcare provider must document the following information:

• Patient’s diagnosis of a vertebral fracture or dislocation in the lumbar region
• Description of the procedure performed, including the approach used
• Specific vertebra or segment treated
• Details of any spinal instrumentation used, if applicable
• Any additional procedures performed in conjunction with CPT 22325
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 22325, it is important to ensure that the procedure meets the criteria for open treatment and/or reduction of a vertebral fracture or dislocation in the lumbar region using a posterior approach. It should not be reported with codes 22511, 22512, 22514, or 22515 when performed at the same level. It is also important to note that spinal instrumentation, if used, should be reported separately.

8. Historical information

CPT code 22325 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 on the Inpatient Only (IPO) list for Medicare. As of 2022, it is once again included on the IPO list.

9. Similar codes to CPT 22325

There are several similar codes to CPT 22325 that describe different procedures for the treatment of vertebral fractures and dislocations in the lumbar region. These include:

• CPT 22310: Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 vertebral segment cervical
• CPT 22315: Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 vertebral segment thoracic
• CPT 22318: Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 vertebral segment thoracolumbar
• CPT 22326: Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 2-3 vertebral segments lumbar
• CPT 22328: Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 4 or more vertebral segments lumbar

9. Examples

1. A patient with a fractured vertebra in the lumbar region undergoes open treatment and reduction using a posterior approach.
2. A healthcare provider performs open reduction of a dislocated segment in the lumbar spine using a posterior approach.
3. A patient with a vertebral fracture in the lumbar region undergoes open treatment and reduction with the application of spinal instrumentation.
4. A healthcare provider performs open treatment and reduction of a fractured vertebra in the lumbar region, along with additional procedures at the same level.
5. A patient with a dislocated segment in the lumbar spine undergoes open reduction using a posterior approach, followed by the application of spinal instrumentation.
6. A healthcare provider performs open treatment and reduction of a fractured vertebra in the lumbar region, along with open treatment of a separate vertebral fracture in the thoracic region.
7. A patient with a vertebral fracture in the lumbar region undergoes open treatment and reduction, followed by the application of spinal instrumentation and fusion.
8. A healthcare provider performs open reduction of a dislocated segment in the lumbar spine, along with open treatment of a separate vertebral fracture in the cervical region.
9. A patient with a fractured vertebra in the lumbar region undergoes open treatment and reduction using a posterior approach, followed by the application of spinal instrumentation and fusion.
10. A healthcare provider performs open treatment and reduction of a fractured vertebra in the lumbar region, along with open treatment of a separate vertebral fracture in the thoracolumbar region.