How To Use CPT Code 22556

CPT code 22556 describes a specific arthrodesis procedure known as the anterior interbody technique. 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 22556?

CPT 22556 is a code that represents the anterior interbody technique for arthrodesis procedures on the thoracic spine. This procedure involves the fusion of two vertebrae in the upper back to alleviate persistent pain caused by conditions such as herniated or bulging discs. The provider makes an incision in the side of the chest to access the spine and remove the damaged disc material.

2. Official Description

The official description of CPT code 22556 is: ‘Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression) thoracic.’

3. Procedure

During the procedure represented by CPT code 22556, the provider performs the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the side of the chest between the ribs.
3. The lungs and great vessels are retracted to access the thoracic spine.
4. The target vertebrae are identified.
5. The provider removes the annulus and uses a curette to remove some of the disc material, creating space inside.
6. The bony end plate is drilled, and bone graft is inserted into the empty disc space.
7. The area is irrigated, checked for bleeding, and any instruments are removed.
8. The incision is closed.

4. Qualifying circumstances

CPT code 22556 is used for arthrodesis procedures on the thoracic spine using the anterior interbody technique. It is typically performed to address persistent pain caused by conditions such as herniated or bulging discs. The procedure involves the fusion of two vertebrae in the upper back. It is important to note that this code does not include the harvest of spinal bone grafts or spinal instrumentation, which should be reported separately.

5. When to use CPT code 22556

CPT code 22556 should be used when the provider performs an arthrodesis procedure on the thoracic spine using the anterior interbody technique. This code is specifically for cases where minimal discectomy is performed to prepare the interspace, excluding cases performed for decompression purposes.

6. Documentation requirements

To support a claim for CPT code 22556, the provider must document the following information:

• Patient’s diagnosis and the need for arthrodesis
• Specific details of the procedure, including the use of the anterior interbody technique
• Date of the procedure
• Incision site and approach
• Details of the discectomy and interspace preparation
• Insertion of bone graft
• Confirmation of irrigation and absence of bleeding
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 22556, ensure that the procedure performed matches the description of the code. It is important to note that this code does not include the harvest of spinal bone grafts or spinal instrumentation, which should be reported separately. Additionally, follow any specific billing guidelines provided by payers or regulatory bodies.

8. Historical information

CPT code 22556 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, including a code change in 2007 to clarify the description. It was also added and removed from the Inpatient Only (IPO) list by Medicare in 2017 and 2021, respectively.

9. Similar codes to CPT 22556

There are several similar codes to CPT code 22556 that represent different approaches and techniques for arthrodesis procedures on the spine. Some examples include:

• CPT 22548: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression) cervical
• CPT 22554: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression) lumbar
• CPT 22558: Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression) lumbar; each additional interspace (List separately in addition to code for primary procedure)

9. Examples

Here are some examples of cases where CPT code 22556 may be used:

1. A patient with persistent upper back pain undergoes an arthrodesis procedure using the anterior interbody technique to fuse two thoracic vertebrae.
2. A provider performs an anterior interbody arthrodesis procedure on a patient with a herniated disc in the thoracic spine, using minimal discectomy to prepare the interspace.
3. A patient with a bulging disc in the upper back undergoes an arthrodesis procedure using the anterior interbody technique to alleviate their pain.
4. A provider performs an arthrodesis procedure on the thoracic spine using the anterior interbody technique to address persistent pain caused by a degenerative spinal condition.
5. A patient with a thoracic disc herniation undergoes an arthrodesis procedure using the anterior interbody technique to fuse the affected vertebrae and relieve their symptoms.