How To Use CPT Code 22327

CPT code 22327 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 22327?

CPT 22327 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 thoracic region of the spine.

2. Official Description

The official description of CPT code 22327 is: ‘Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment thoracic.’

3. Procedure

During the procedure, the healthcare provider begins by making an incision over the affected vertebra in the thoracic region of the 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 22327 is used for patients who have a vertebral fracture or dislocation in the thoracic region of the spine that requires open treatment and/or reduction. It is important to note that CPT 22327 should not be reported in conjunction with codes 22510, 22512, 22513, or 22515 when performed at the same level.

5. When to use CPT code 22327

CPT code 22327 should be used when a healthcare provider performs open treatment and/or reduction of a vertebral fracture or dislocation in the thoracic 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 22327, the healthcare provider must document the following information:

• Patient’s diagnosis of a vertebral fracture or dislocation
• Specific details of the procedure performed, including the approach used
• Location of the fractured vertebra or dislocated segment
• Any spinal instrumentation applied, if applicable
• Details of any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 22327, it is important to ensure that the procedure meets the criteria outlined in the code description. Additionally, CPT 22327 should not be reported in conjunction with codes 22510, 22512, 22513, or 22515 when performed at the same level. It is also important to note that Medicare has made changes regarding the inpatient-only (IPO) list for CPT 22327, so it is essential to review the latest guidelines for accurate billing.

8. Historical information

CPT code 22327 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 code description and its inclusion on the Medicare inpatient-only (IPO) list.

9. Similar codes to CPT 22327

There are several similar codes to CPT 22327 that describe open treatment and/or reduction of vertebral fractures or dislocations in different regions of the spine. Some similar codes 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 lumbar
• CPT 22318: Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 vertebral segment lumbar; with decompression of neural elements (eg, spinal cord, cauda equina) (List separately in addition to code for primary procedure)
• CPT 22325: Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 vertebral segment thoracic; with decompression of neural elements (eg, spinal cord, cauda equina) (List separately in addition to code for primary procedure)
• CPT 22328: Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 vertebral segment thoracic; with decompression of neural elements (eg, spinal cord, cauda equina) (List separately in addition to code for primary procedure)

9. Examples

1. A patient undergoes open treatment and reduction of a fractured vertebra in the thoracic region of the spine using a posterior approach.
2. A healthcare provider performs open reduction of a dislocated segment in the thoracic region of the spine using a posterior approach.
3. A patient with a vertebral fracture in the thoracic region undergoes open treatment and reduction of the fracture using a posterior approach.
4. A healthcare provider performs open reduction of a dislocated segment in the thoracic region of the spine and applies spinal instrumentation for stabilization.
5. A patient undergoes open treatment and reduction of a fractured vertebra in the thoracic region of the spine, along with decompression of neural elements.
6. A healthcare provider performs open reduction of a dislocated segment in the thoracic region of the spine, along with decompression of neural elements.
7. A patient with a vertebral fracture in the thoracic region undergoes open treatment and reduction of the fracture, along with decompression of neural elements.
8. A healthcare provider performs open reduction of a dislocated segment in the thoracic region of the spine, applies spinal instrumentation, and decompresses neural elements.
9. A patient undergoes open treatment and reduction of a fractured vertebra in the thoracic region of the spine, along with decompression of neural elements and application of spinal instrumentation.