How To Use CPT Code 22819

CPT code 22819 describes the surgical procedure known as kyphectomy, which involves the circumferential exposure of the spine and resection of three or more vertebral segments, including the body and posterior elements. 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 22819?

CPT 22819 is a code used to describe the surgical procedure known as kyphectomy. This procedure involves the circumferential exposure of the spine and the resection of three or more vertebral segments, including the body and posterior elements. Kyphectomy is performed to alleviate persistent pain caused by various spinal deformities, such as spina bifida or kyphosis.

2. Official Description

The official description of CPT code 22819 is: ‘Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements) 3 or more segments.’

3. Procedure

The kyphectomy procedure involves several steps:

1. The provider makes a midline incision over the spinal deformity.
2. The provider dissects through the muscle and tissue until the foramina on both sides of the affected vertebrae are visible.
3. The provider dissects the dural sac and further dissects down to the intervertebral disk.
4. The provider removes the necessary vertebrae to correct the deformity.
5. The provider covers the resected vertebrae with the dural sac.
6. The provider applies bone grafting to the defect and uses instrumentation, such as wiring or plates, to stabilize the vertebrae.
7. The provider irrigates the wound and closes the incision.
8. The provider may apply a cast or other immobilization device.

4. Qualifying circumstances

CPT 22819 is typically performed on patients with spinal deformities, such as spina bifida or kyphosis, who experience persistent pain. The procedure involves the resection of three or more complete vertebral segments, including the body and posterior elements. It is important to note that CPT code 22819 should not be reported in conjunction with codes 22818, 0656T, or 0657T. If arthrodesis is performed, separate codes should be used, with modifier 51 added.

5. When to use CPT code 22819

CPT code 22819 should be used when a kyphectomy procedure is performed, involving the circumferential exposure of the spine and the resection of three or more vertebral segments. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT code 22819, the following documentation is required:

• Patient’s diagnosis and the need for kyphectomy
• Details of the procedure, including the specific vertebral segments resected
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed, such as bone grafting or spinal instrumentation
• Any complications or unexpected findings
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 22819, it is important to ensure that the procedure meets the specific criteria outlined in the code description. Additionally, it should not be reported in conjunction with codes 22818, 0656T, or 0657T. If arthrodesis is performed, separate codes should be used, with modifier 51 added. It is important to review the specific billing guidelines provided by the payer to ensure accurate and appropriate reimbursement.

8. Historical information

CPT code 22819 was added to the Current Procedural Terminology system on January 1, 1998. Since its addition, there have been several historical changes, including being added and removed from the Inpatient Only (IPO) list for Medicare. It is important to stay updated on any changes or updates to the code.

9. Similar codes to CPT 22819

There are several similar codes to CPT 22819 that may be used in different scenarios. These include:

• CPT 22800: Arthrodesis, posterior or posterolateral technique, single level; cervical
• CPT 22802: Arthrodesis, posterior or posterolateral technique, single level; thoracic
• CPT 22804: Arthrodesis, posterior or posterolateral technique, single level; lumbar
• CPT 22810: Arthrodesis, posterior or posterolateral technique, 2-3 vertebral segments; cervical
• CPT 22812: Arthrodesis, posterior or posterolateral technique, 2-3 vertebral segments; thoracic

9. Examples

1. A patient with severe kyphosis undergoes a kyphectomy procedure to correct the spinal deformity.
2. A patient with spina bifida experiences persistent pain and undergoes a kyphectomy procedure to alleviate the discomfort.
3. A patient with a hunchback deformity undergoes a kyphectomy procedure to improve their posture and alleviate pain.
4. A patient with a spinal deformity resulting from a previous injury undergoes a kyphectomy procedure to correct the alignment of the spine.
5. A patient with kyphosis caused by a degenerative condition undergoes a kyphectomy procedure to improve their mobility and quality of life.
6. A patient with severe spinal curvature undergoes a kyphectomy procedure to prevent further progression of the deformity.
7. A patient with kyphosis experiences significant pain and undergoes a kyphectomy procedure to alleviate their symptoms and improve their overall well-being.
8. A patient with spina bifida and associated spinal deformities undergoes a kyphectomy procedure to improve their mobility and reduce pain.