How To Use CPT Code 22632

CPT 22632 describes a specific procedure known as arthrodesis, which involves the fusion of two vertebrae in the lumbar spine. This article will provide a comprehensive overview of CPT code 22632, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 22632?

CPT 22632 is a code used to describe the arthrodesis procedure, specifically the posterior interbody technique, in the lumbar spine. This procedure involves the fusion of two vertebrae in the lower back to alleviate persistent pain caused by various spinal conditions, such as herniated intervertebral disks, stenosis, or spinal injuries. It may also include a laminectomy and/or discectomy to prepare the interspace for fusion. CPT 22632 is used when this procedure is performed on an additional interspace after completing an initial arthrodesis in the same encounter.

2. Official Description

The official description of CPT code 22632 is: ‘Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar each additional interspace (List separately in addition to code for primary procedure).’ This code should be used when performing a posterior interbody fusion arthrodesis at an additional interspace.

3. Procedure

The procedure for CPT code 22632 involves several steps:

1. The patient is appropriately prepped and anesthetized.
2. An incision is made over the lumbar vertebrae to be fused.
3. The provider separates and moves the soft tissues aside using retractors.
4. Fragments from nearby cortical bone and articular cartilage are excised.
5. A laminectomy and/or discectomy is performed to prepare the interspace for fusion.
6. Bone graft material, such as autograft or allograft, is inserted to fill the gap and fuse the vertebrae.
7. The soft tissues are sutured back to their positions around the graft site.
8. The area is irrigated, checked for bleeding, and the incision is closed in layers.

4. Qualifying circumstances

CPT 22632 is performed on patients who require arthrodesis in the lumbar spine. This procedure is indicated for individuals with persistent pain caused by conditions such as herniated intervertebral disks, stenosis, or spinal injuries. It is important to note that CPT 22632 is used for an additional interspace after completing an initial arthrodesis in the same encounter.

5. When to use CPT code 22632

CPT code 22632 should be used when performing a posterior interbody fusion arthrodesis at an additional interspace in the lumbar spine. It is important to ensure that the procedure meets the specific criteria outlined in the official description of the code. If the procedure does not meet these criteria, an alternative code may be more appropriate.

6. Documentation requirements

To support a claim for CPT code 22632, the following documentation is required:

• Patient’s diagnosis and indication for arthrodesis
• Specific details of the procedure performed, including laminectomy and/or discectomy
• Location and number of interspaces fused
• Type of bone graft material used
• Date of the procedure
• Any additional relevant information or complications

7. Billing guidelines

When billing for CPT code 22632, it is important to follow the appropriate billing guidelines. Ensure that the procedure meets the criteria outlined in the official description of the code. Additionally, be aware of any specific guidelines or restrictions set by payers or insurance companies. It is also important to accurately report any additional procedures or services performed in conjunction with CPT code 22632.

8. Historical information

CPT code 22632 was added to the Current Procedural Terminology system on January 1, 1996. Since its addition, there have been several historical changes and updates to the code. These changes include updates to the code description and its inclusion or exclusion from the Inpatient Only (IPO) list for Medicare billing purposes.

9. Similar codes to CPT 22632

There are several similar codes to CPT 22632 that may be used in different scenarios. These codes include:

• CPT 22612: Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, cervical
• CPT 22630: Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, thoracic
• CPT 22633: Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), each additional interspace, cervical (List separately in addition to code for primary procedure)
• CPT 22614: Arthrodesis, posterior or posterolateral technique, single level; lumbar
• CPT 22634: Arthrodesis, posterior or posterolateral technique, single level; each additional lumbar interspace (List separately in addition to code for primary procedure)

9. Examples

1. A patient with a herniated intervertebral disk undergoes a posterior interbody fusion arthrodesis at the L4-L5 level using CPT code 22632.
2. A provider performs a laminectomy and discectomy to prepare the interspace for fusion, and then fuses the L3-L4 and L5-S1 levels using CPT code 22632.
3. During a single encounter, a patient undergoes an initial arthrodesis at the L2-L3 level, followed by an additional arthrodesis at the L4-L5 level using CPT code 22632.