How To Use CPT Code 22600

CPT 22600 describes a surgical procedure known as arthrodesis, specifically the posterior or posterolateral technique, performed on a single interspace in the cervical spine below the C2 segment. This article will provide a comprehensive overview of CPT code 22600, including its description, official definition, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 22600?

CPT 22600 is a code used to describe a surgical procedure called arthrodesis, which involves the fusion of two vertebrae in the cervical spine. This procedure is performed using the posterior or posterolateral technique and is specifically applicable to a single interspace below the C2 segment.

2. Official Description

The official description of CPT code 22600 is: ‘Arthrodesis, posterior or posterolateral technique, single interspace cervical below C2 segment.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. A midline incision is made over the affected vertebrae in the cervical spine below the C2 segment.
3. The provider dissects through the subcutaneous tissue and muscles to visualize the bone.
4. The muscles are stripped from the spinous process and posterior lamina out to the mid-portion of the facet joints.
5. Decortication, the removal of the outer layer of bone, is performed using bone cutting instruments.
6. Bone graft material, which may be obtained from surrounding structures, is applied to the prepared bony surfaces at the back of the vertebrae or at the back and side.
7. Metal implants may be inserted to hold the vertebrae together until new bone growth occurs.
8. The muscles and ligaments are sutured over the grafted areas, and the area is irrigated and checked for bleeding.
9. Any instruments are removed, and the incision is closed.
10. A brace or immobilization device may be applied.

4. Qualifying circumstances

CPT code 22600 is applicable to patients who require arthrodesis in the cervical spine below the C2 segment. This procedure is typically performed to alleviate persistent pain caused by various spinal conditions, such as herniated intervertebral disks, stenosis, and spinal injuries. It is important to note that the procedure must be performed using the posterior or posterolateral technique and involve a single interspace.

5. When to use CPT code 22600

CPT code 22600 should be used when a provider performs arthrodesis using the posterior or posterolateral technique on a single interspace in the cervical spine below the C2 segment. It is important to ensure that the procedure meets all the qualifying circumstances mentioned above to accurately report this code.

6. Documentation requirements

When reporting CPT code 22600, the following documentation should be included:

• Patient’s diagnosis and the medical necessity for arthrodesis
• Details of the procedure, including the specific interspace and the technique used (posterior or posterolateral)
• Description of any bone graft material used and its source
• Documentation of any metal implants inserted, if applicable
• Information on any additional procedures performed, such as decortication
• Documentation of any complications or unexpected findings
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 22600, it is important to ensure that the procedure meets all the qualifying circumstances and documentation requirements. This code should not be reported with other codes unless there are additional procedures performed that warrant separate reporting. It is advisable to review coding and payer guidelines to determine if graft harvesting can be reported separately in specific cases.

8. Historical information

CPT code 22600 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been several historical changes, including updates to the code description and its inclusion or exclusion from the Inpatient Only (IPO) list for Medicare reimbursement. The most recent change occurred on January 1, 2022, when CPT code 22600 was added back to the IPO list for Medicare reimbursement.

9. Examples

1. A patient with a herniated intervertebral disc in the cervical spine below the C2 segment undergoes arthrodesis using the posterior technique on a single interspace.
2. A patient with spinal stenosis in the cervical spine below the C2 segment undergoes arthrodesis using the posterolateral technique on a single interspace.
3. A patient with a spinal injury in the cervical spine below the C2 segment undergoes arthrodesis using the posterior technique on a single interspace.
4. A patient with a herniated intervertebral disc and stenosis in the cervical spine below the C2 segment undergoes arthrodesis using the posterolateral technique on a single interspace.
5. A patient with a spinal injury and stenosis in the cervical spine below the C2 segment undergoes arthrodesis using the posterior technique on a single interspace.
6. A patient with a herniated intervertebral disc and spinal injury in the cervical spine below the C2 segment undergoes arthrodesis using the posterolateral technique on a single interspace.