How To Use CPT Code 22586
CPT code 22586 describes a surgical procedure known as arthrodesis, specifically the pre-sacral interbody technique. This article will provide a comprehensive overview of CPT code 22586, 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 22586.
1. What is CPT Code 22586?
CPT code 22586 is used to describe the surgical procedure of arthrodesis, specifically the pre-sacral interbody technique. This procedure involves permanently joining two vertebrae in the lower back, specifically at the L5-S1 interspace. The surgeon performs a disc space preparation and discectomy, and utilizes posterior instrumentation with image guidance. If bone grafting is necessary, it is also included in this procedure.
2. Official Description
The official description of CPT code 22586 is: ‘Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspace.’ It is important to note that this code should not be reported in conjunction with codes 20930-20938, 22840, 22848, 77002, 77003, 77011, or 77012.
3. Procedure
The surgical procedure for CPT code 22586 involves several steps:
- The patient is appropriately prepped and anesthetized.
- An incision is made at the center of the lower back, between the L5 and S1 vertebrae.
- The surgeon gains access to the presacral space and removes fatty tissues for clear visualization.
- Under image guidance, the surgeon performs a discectomy, excising the herniated nucleus pulposus that was causing pain.
- The disc space is prepared, smoothing the roof and floor of the L5 and S1 vertebrae.
- If necessary, bone graft material is harvested and mixed with bone cement, which is applied between the vertebrae to promote fusion.
- Posterior spinal instrumentation, such as rods, hooks, and screws, is applied for stabilization.
- The surgical site is irrigated, checked for bleeding, instruments are removed, and the incision is closed.
