How To Use CPT Code 22800

CPT 22800 describes the procedure of arthrodesis, also known as spinal fusion, for spinal deformities such as scoliosis or kyphosis. 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 22800?

CPT 22800 is a code used to describe the arthrodesis procedure for spinal deformities. Arthrodesis, also known as spinal fusion, involves securing different vertebrae to one another to treat and alleviate persistent pain caused by conditions like scoliosis or kyphosis. This procedure can be performed on up to six vertebral segments and may involve the application of a body cast.

2. Official Description

The official description of CPT code 22800 is: ‘Arthrodesis, posterior, for spinal deformity, with or without cast up to 6 vertebral segments.’

3. Procedure

During the arthrodesis procedure, the healthcare provider makes a midline incision over the vertebrae that require fusion. They then dissect the fascia and muscles from the lateral surfaces of the spinous processes, laminae, facets, and transverse processes. Soft tissue, including interspinous ligaments, is removed from the exposed areas of the bone, while excluding the ligamentum flavum. The provider also removes the capsules of the facets and cuts or removes the cortices of all exposed bone surfaces, shingling them to expose cancellous bone. Bone grafting material is applied to the prepared bony surfaces, and the incision is closed in layers. In some cases, a cast or other immobilization device may be applied.

4. Qualifying circumstances

CPT 22800 is used for patients with spinal deformities, such as scoliosis or kyphosis, that require arthrodesis for treatment. The procedure is performed on the posterior aspect of the spine and can involve up to six vertebral segments. The specific qualifying circumstances may vary depending on the patient’s condition and the healthcare provider’s clinical judgment.

5. When to use CPT code 22800

CPT code 22800 should be used when a healthcare provider performs arthrodesis for spinal deformities, with or without the application of a cast, on up to six vertebral segments. It is important to ensure that the procedure performed aligns with the official description of the code and meets the necessary qualifying circumstances.

6. Documentation requirements

To support a claim for CPT 22800, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for arthrodesis
• Details of the procedure performed, including the number of vertebral segments involved
• Date of the procedure
• Any additional procedures or techniques used during the arthrodesis
• Any complications or unexpected findings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 22800, ensure that the procedure performed aligns with the official description of the code. It is important to follow the specific guidelines provided by the payer and accurately document the details of the procedure to support the claim. Additionally, it is essential to report any additional procedures or techniques separately, as they may require their own specific codes.

8. Historical information

CPT 22800 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, including being added and removed from the Inpatient Only (IPO) list for Medicare. It is important to stay updated with any changes or revisions to ensure accurate coding and billing.

9. Similar codes to CPT 22800

There are several similar codes to CPT 22800 that may be used for different procedures or circumstances. Some examples include:

• CPT 22802: Arthrodesis, posterior, for spinal deformity, with or without cast, with segmental instrumentation, when performed
• CPT 22804: Arthrodesis, posterior, for spinal deformity, with or without cast, with interbody technique including minimal discectomy to prepare interspace (other than for decompression); 1 interspace, lumbar
• CPT 22808: Arthrodesis, posterior, for spinal deformity, with or without cast, with interbody technique including minimal discectomy to prepare interspace (other than for decompression); 2 interspaces, lumbar
• CPT 22810: Arthrodesis, posterior, for spinal deformity, with or without cast, with interbody technique including minimal discectomy to prepare interspace (other than for decompression); 3 or more interspaces, lumbar
• CPT 22812: Arthrodesis, posterior, for spinal deformity, with or without cast, with interbody technique including minimal discectomy to prepare interspace (other than for decompression); 1 interspace, cervical

9. Examples

1. A patient with severe scoliosis undergoes arthrodesis on four vertebral segments to correct the spinal deformity.
2. An individual with kyphosis requires arthrodesis on six vertebral segments to alleviate pain and improve spinal alignment.
3. A healthcare provider performs arthrodesis on three vertebral segments for a patient with a combination of scoliosis and kyphosis.
4. Arthrodesis is performed on two vertebral segments for a patient with a spinal deformity resulting from a previous injury.
5. A child with congenital scoliosis undergoes arthrodesis on five vertebral segments to prevent further progression of the deformity.
6. An adult with degenerative scoliosis requires arthrodesis on three vertebral segments to address pain and instability in the spine.
7. A patient with kyphoscoliosis undergoes arthrodesis on six vertebral segments to correct the abnormal curvature of the spine.
8. An elderly individual with osteoporosis-related kyphosis undergoes arthrodesis on four vertebral segments to improve spinal alignment and alleviate pain.
9. A healthcare provider performs arthrodesis on three vertebral segments for a patient with a spinal deformity resulting from a genetic condition.