How To Use CPT Code 22533

CPT code 22533 describes a specific arthrodesis procedure known as the lateral extracavitary technique. This article will provide a comprehensive overview of CPT code 22533, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when to use CPT code 22533.

1. What is CPT Code 22533?

CPT code 22533 is used to describe a surgical procedure called arthrodesis, specifically the lateral extracavitary technique. This procedure involves the fusion of two or more vertebrae in the lumbar spine to restore mobility and alleviate persistent pain caused by conditions such as herniated discs, spinal stenosis, or spinal injuries. The surgeon accesses the spine from the sides of the vertebrae without entering the chest cavity, performing a minimal discectomy to prepare the interspace for fusion.

2. Official Description

The official description of CPT code 22533 is: ‘Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression) lumbar.’

3. Procedure

The lateral extracavitary technique arthrodesis procedure involves several steps:

1. The patient is appropriately prepped and anesthetized.
2. A midline incision is made over the damaged vertebrae.
3. The paraspinous muscles, which are the spinal muscles, are elevated from the spinous processes.
4. The vertebral surface or lamina is removed using an electrocautery device.
5. The associated transverse process, lateral portion of the facet, and pedicle are removed with a drill.
6. The lateral aspect of the dural sac and the dorsolateral aspect of the vertebral body are exposed.
7. The parietal pleura, the membrane lining the chest cavity, is depressed and retracted to expose the lateral surface of the vertebral body.
8. The degenerated disc material is removed, and the cartilage is scraped from the vertebral end plates.
9. The bone is treated with a high-speed drill.
10. Bone graft material is inserted and tapped into position between the end plates for interbody arthrodesis.
11. The area is irrigated, checked for bleeding, and the incision is closed.

4. Qualifying circumstances

CPT code 22533 is used for patients who require arthrodesis using the lateral extracavitary technique. This procedure is typically performed on patients with conditions such as herniated discs, spinal stenosis, or spinal injuries that cause persistent pain and require fusion of the vertebrae. It is important to note that this code is specifically for the lateral extracavitary technique and should not be used for other arthrodesis procedures.

5. When to use CPT code 22533

CPT code 22533 should be used when a surgeon performs arthrodesis using the lateral extracavitary technique, including a minimal discectomy to prepare the interspace for fusion. It is important to ensure that the procedure performed aligns with the official description of the code to accurately report it.

6. Documentation requirements

To support a claim for CPT code 22533, the surgeon must document the following information:

• Patient’s diagnosis and the need for arthrodesis using the lateral extracavitary technique
• Details of the procedure performed, including the minimal discectomy and interspace preparation
• Date of the procedure
• Start and end time of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT code 22533, it is important to ensure that the procedure performed aligns with the official description of the code. This code should not be reported with other codes that are not applicable to the lateral extracavitary technique. It is essential to follow the specific guidelines provided by the payer and accurately document the procedure to support the claim.

8. Historical information

CPT code 22533 was added to the Current Procedural Terminology system on January 1, 2004. Since its addition, there have been several historical changes, including code updates and Medicare changes. It is important to stay updated with any changes or revisions to ensure accurate reporting and billing.

9. Similar codes to CPT 22533

There are several similar codes to CPT code 22533 that are used to describe different arthrodesis procedures on the spine. These codes include:

• CPT 22532: Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression) lumbar
• CPT 22534: Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression) lumbar

9. Examples

Here are some examples of cases where CPT code 22533 may be used:

1. A patient with a herniated disc in the lumbar spine undergoes arthrodesis using the lateral extracavitary technique, including a minimal discectomy to prepare the interspace.
2. A patient with spinal stenosis requires fusion of the vertebrae in the lumbar spine using the lateral extracavitary technique, including a minimal discectomy.
3. A patient with a spinal injury undergoes arthrodesis using the lateral extracavitary technique, including a minimal discectomy to prepare the interspace for fusion.