How To Use CPT Code 22802

CPT 22802 describes the arthrodesis procedure for spinal deformity, specifically for securing seven to twelve vertebral segments. 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 22802?

CPT 22802 is a code used to describe the arthrodesis procedure for spinal deformity. Arthrodesis, also known as spinal fusion, involves securing different vertebrae to one another to treat and alleviate persistent pain caused by spinal deformities such as scoliosis or kyphosis. This specific code is used when the provider performs the procedure on seven to twelve vertebral segments.

2. Official Description

The official description of CPT code 22802 is: ‘Arthrodesis, posterior, for spinal deformity, with or without cast 7 to 12 vertebral segments.’

3. Procedure

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

4. Qualifying circumstances

Patients who may require arthrodesis for spinal deformity are those with conditions such as scoliosis or kyphosis, which cause abnormal curvatures of the spine. The procedure is performed on seven to twelve vertebral segments. The provider must assess the patient’s condition and determine the need for arthrodesis. It is important to note that arthrodesis codes do not include the harvest of spinal bone grafts or spinal instrumentation, which should be reported separately.

5. When to use CPT code 22802

CPT code 22802 should be used when the provider performs arthrodesis for spinal deformity on seven to twelve vertebral segments. It is important to ensure that the procedure aligns with the official description and meets the qualifying circumstances mentioned above.

6. Documentation requirements

To support a claim for CPT code 22802, the provider must document the following information:

• Patient’s diagnosis and the need for arthrodesis
• Number of vertebral segments involved in the procedure
• Details of the procedure, including the specific techniques used
• Any additional procedures performed, such as bone grafting or application of a cast
• Incision details and closure method
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 22802, ensure that the procedure aligns with the official description and meets the qualifying circumstances. It is important to note that arthrodesis codes do not include the harvest of spinal bone grafts or spinal instrumentation, which should be reported separately. Follow the appropriate coding guidelines and modifiers when reporting this code.

8. Historical information

CPT code 22802 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, including its addition and removal from the Inpatient Only (IPO) list for Medicare. It is important to stay updated with any changes or updates related to this code.

9. Similar codes to CPT 22802

There are several similar codes to CPT 22802 that describe arthrodesis procedures for spinal deformity involving different vertebral segments. Some of these codes include:

• CPT 22800: Arthrodesis, posterior, for spinal deformity, with or without cast 1 to 3 vertebral segments
• CPT 22810: Arthrodesis, posterior, for spinal deformity, with or without cast 4 to 6 vertebral segments
• CPT 22812: Arthrodesis, posterior, for spinal deformity, with or without cast 13 or more vertebral segments
• CPT 22818: Arthrodesis, posterior, for spinal deformity, with or without cast; lumbar
• CPT 22819: Arthrodesis, posterior, for spinal deformity, with or without cast; lumbosacral

9. Examples

1. A patient with severe scoliosis undergoes arthrodesis on eight vertebral segments to correct the spinal deformity.
2. An individual with kyphosis requires arthrodesis on ten vertebral segments to alleviate pain and improve spinal alignment.
3. A patient with a combination of scoliosis and kyphosis undergoes arthrodesis on twelve vertebral segments to address both deformities.
4. An individual with spinal deformity resulting from a previous injury undergoes arthrodesis on seven vertebral segments to stabilize the spine.
5. A patient with congenital spinal deformity undergoes arthrodesis on nine vertebral segments to improve spinal alignment and function.
6. An individual with degenerative spinal deformity undergoes arthrodesis on eleven vertebral segments to alleviate pain and improve stability.
7. A patient with idiopathic scoliosis undergoes arthrodesis on eight vertebral segments to correct the curvature of the spine.
8. An individual with postural kyphosis undergoes arthrodesis on ten vertebral segments to improve spinal alignment and posture.
9. A patient with neuromuscular scoliosis undergoes arthrodesis on twelve vertebral segments to address the spinal deformity caused by the underlying condition.
10. An individual with traumatic spinal deformity undergoes arthrodesis on seven vertebral segments to stabilize the spine and prevent further complications.