How To Use CPT Code 22554

CPT code 22554 describes the anterior interbody technique for arthrodesis, which involves joining two vertebrae in the neck to alleviate persistent pain caused by a herniated or bulging disk or other spinal condition. 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 22554?

CPT 22554 is used to describe the anterior interbody technique for arthrodesis in the cervical spine. This procedure involves permanently joining two vertebrae in the neck to alleviate persistent pain caused by a herniated or bulging disk or other spinal condition. The provider makes an incision in the front of the neck, removes the disk material, and inserts bone graft into the empty disk space to promote fusion between the vertebrae.

2. Official Description

The official description of CPT code 22554 is: ‘Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression) cervical below C2.’

3. Procedure

During the procedure for CPT 22554, the provider follows these steps:

1. The patient is appropriately prepped and anesthetized.
2. An incision is made in the front of the neck to gain access to the cervical spine.
3. The provider dissects the prevertebral fascia and platysma muscle over the cervical intervertebral disk.
4. Tissues and muscles are retracted to expose the disk.
5. The provider removes the annulus, the fibrous outer ring of the intervertebral disk.
6. Using a curette, the provider removes some of the disk material to create space inside.
7. The bony end plate is drilled to prepare for the insertion of bone graft.
8. Bone graft is inserted into the empty disk space.
9. The area is irrigated, checked for bleeding, and any instruments are removed.
10. The incision is closed.

4. Qualifying circumstances

CPT 22554 is performed on patients who experience persistent pain due to a herniated or bulging disk or other spinal condition in the cervical spine. The procedure is indicated when other conservative treatments have failed to alleviate the pain. It is important to note that CPT 22554 should not be reported in conjunction with CPT 63075, even if performed by a separate individual. To report anterior cervical discectomy and interbody fusion at the same level during the same session, use CPT 22551.

5. When to use CPT code 22554

CPT code 22554 should be used when the provider performs the anterior interbody technique for arthrodesis in the cervical spine, including minimal discectomy to prepare the interspace. This code is appropriate when the procedure is performed below the C2 level and is not for decompression purposes.

6. Documentation requirements

To support a claim for CPT 22554, the provider must document the following information:

• Patient’s diagnosis and the need for arthrodesis
• Specific details of the procedure, including the level of the cervical spine
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed during the same session
• Any complications or unexpected findings
• Signature of the provider

7. Billing guidelines

When billing for CPT 22554, ensure that the procedure meets the criteria for this code. It is important to note that CPT 22554 should not be reported with CPT 63075, even if performed by a separate individual. To report anterior cervical discectomy and interbody fusion at the same level during the same session, use CPT 22551. Additionally, report any separately identifiable services performed during the same session with the appropriate modifier.

8. Historical information

CPT 22554 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2007, with a modification to the description.

9. Similar codes to CPT 22554

There are several similar codes to CPT 22554 that describe arthrodesis procedures on the spine. These include:

• CPT 22548: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression) lumbar
• CPT 22585: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression) lumbar below L5-S1
• CPT 22586: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression) lumbar below L5-S1; each additional interspace (List separately in addition to code for primary procedure)

9. Examples

Here are some examples of cases where CPT code 22554 would be appropriate:

1. A patient with persistent neck pain due to a herniated disk undergoes anterior interbody arthrodesis at the C4-C5 level.
2. A patient with a bulging disk in the cervical spine undergoes anterior interbody arthrodesis at the C6-C7 level.
3. A patient with degenerative disc disease in the cervical spine undergoes anterior interbody arthrodesis at the C3-C4 level.
4. A patient with cervical spondylosis and radiculopathy undergoes anterior interbody arthrodesis at the C5-C6 level.
5. A patient with cervical instability due to trauma undergoes anterior interbody arthrodesis at the C2-C3 level.