cpt 22840, cpt code 22840, 22840 cpt code

CPT Code 22840 | Description, Procedure & Billing Guidelines (2022)

Report add-on code 22840 if spinal instrumentation placement across a single interspace (C1 -C2) was performed during a primary spinal procedure.

1. What Is CPT Code 22840?

CPT 22840 is an add-on code and covers spinal instrumentation placement in the patient’s neck across a single interspace (C1-C2).

This procedure aims to correct spinal deformity and is provided during primary spinal surgery (for example, arthrodesis or spinal fusion).

2. Description

The CPT book defines CPT code 22840 as follows: “Posterior non-segmental instrumentation (e.g., Harrington rod technique, pedicle fixation across one interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation).”

3. Procedure

The 22840 add-on procedure begins during a primary spinal surgery. The provider assesses the alignment of C1 and C2 with fluoroscopy before they make the incision on the back of the patient’s neck (caudally).

Then, they use a trocar to insert the C1-C2 transarticular screw. Next, they remove the obturator that covered the trocar opening (a little hole for fluoroscopic guidance).

Next, they place a cannulated screw with a hollow shaft across the C1-C2 joint. They repeated the procedure on the vertebra’s opposite side.

Finally, they end the add-on procedure and continue with the primary spinal surgery.

4. How To Use CPT Code 22840

CPT code 22840 is an add-on procedure and can not be billed by itself.

You can use CPT 22840 with the following CPT codes; CPT 22100, CPT 22101, CPT 22102, CPT 22110 to CPT 22114, CPT 22206, CPT 22207, CPT 22210 to CPT 22214, CPT 22220 to CPT 22224, CPT 22310 to CPT 22327, CPT 22532, CPT 22533, CPT 22548 to CPT 22558, CPT 22590 to CPT 22612, CPT 22630, CPT 22633, CPT 22634, CPT 22800 to 22812, CPT 63001 to CPT 63030, CPT 63040 to CPT 63042, CPT 63045 to CPT 63047, CPT 63050 to CPT 63056, CPT 63064, CPT 63075, CPT 63077, CPT 63081, CPT 63085, CPT 63087, CPT 63090, CPT 63101, CPT 63102, CPT 63170 to CPT 63290, and CPT 63300 to CPT 63307.

Spinal instrumentation can be billed with code range CPT 22840 to CPT 22870. To confirm that CPT 22840 is the correct code, you may check the approach (posterior or anterior) before determining whether the device is nonsegmental or segmental. Next, you can count the fixation points and confirm the removal of vertebral portions.

Report instrumentation removal separately if the provider removed it because of rejection, damage, or adjustments.

You may want to add modifier 59 to CPT code 22840 if the payer wants you to demonstrate that the surgeon performed instrumentation at separate anatomic sites.

5. Resources

CPT Professional 2022

https://www.aapc.com/blog/25658-procedure-coding-made-simple/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186910/

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