How To Use CPT Code 22841

CPT 22841 describes the internal spinal fixation procedure known as wiring of spinous processes. 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 22841?

CPT 22841 is a code used to describe the internal spinal fixation procedure known as wiring of spinous processes. This procedure involves the use of wires and buttons to fixate the spinous processes at a specific vertebral segment level during a spinal surgery, such as a spinal fusion or arthrodesis.

2. Official Description

The official description of CPT code 22841 is: ‘Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure).’ This code is an add-on code and should be reported in conjunction with the primary procedure code for the spinal surgery.

3. Procedure

During the internal spinal fixation procedure using wiring of spinous processes, the provider begins by drilling a hole at the base of each spinous process at the targeted vertebral segment level. Wires are then passed through these holes and buttons are applied to fixate the wires at the base of the spinous processes. Hooks and clamps may also be used to ensure secure fixation of the wiring system. The provider then continues with the primary procedure, such as a spinal fusion, to complete the surgery and closes the wound.

4. Qualifying circumstances

CPT 22841 is used when the internal spinal fixation procedure involving wiring of spinous processes is performed in addition to the primary procedure. It is important to note that this code should only be reported when the provider has also performed one of the qualifying primary procedures listed in the notes section of the code, such as spinal fusion or arthrodesis.

5. When to use CPT code 22841

CPT code 22841 should be used when the provider performs the internal spinal fixation procedure using wiring of spinous processes in addition to the primary procedure, such as spinal fusion or arthrodesis. It is important to ensure that the documentation clearly supports the performance of this specific procedure and that it is reported in conjunction with the appropriate primary procedure code.

6. Documentation requirements

To support a claim for CPT code 22841, the provider must document the following information:

• Performance of the internal spinal fixation procedure using wiring of spinous processes
• Specific vertebral segment level at which the procedure was performed
• Documentation supporting the performance of the primary procedure
• Any additional instrumentation or hardware used during the procedure
• Details of the closure of the wound

7. Billing guidelines

When billing for CPT code 22841, it is important to ensure that the procedure was performed in addition to the primary procedure, such as spinal fusion or arthrodesis. This code should be reported as an add-on code and should be listed separately in addition to the primary procedure code. It is also important to follow any specific billing guidelines provided by payers and to ensure accurate documentation and coding to support the claim.

8. Historical information

CPT code 22841 was added to the Current Procedural Terminology system on January 1, 1996. Since its addition, there have been several historical changes to the code, including code changes in 2008 and Medicare changes in 2017 and 2021.

9. Similar codes to CPT 22841

There are several similar codes to CPT 22841 that are used to describe other spinal instrumentation procedures. Some examples of similar codes include:

• CPT 22840: Internal spinal fixation by wiring of spinous processes, each additional vertebral segment (List separately in addition to code for primary procedure)
• CPT 22842: Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, lumbar; single level
• CPT 22843: Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, lumbar; each additional level (List separately in addition to code for primary procedure)
• CPT 22844: Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, cervical; single level
• CPT 22845: Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, cervical; each additional level (List separately in addition to code for primary procedure)

9. Examples

1. A patient undergoes a spinal fusion surgery at the L4-L5 level, and the provider also performs internal spinal fixation by wiring of spinous processes at the same level using CPT code 22841.
2. During a spinal arthrodesis procedure at the C6-C7 level, the provider utilizes wiring of spinous processes for internal spinal fixation, which is reported with CPT code 22841.
3. A patient undergoes a lumbar spinal fusion surgery at the L2-L3 level, and the provider performs internal spinal fixation by wiring of spinous processes at the L2-L3 level in addition to the fusion, which is reported with CPT code 22841.
4. During a cervical spinal fusion surgery at the C3-C4 level, the provider utilizes wiring of spinous processes for internal spinal fixation, which is reported with CPT code 22841.
5. A patient undergoes a spinal arthrodesis procedure at the T10-T11 level, and the provider performs internal spinal fixation by wiring of spinous processes at the same level using CPT code 22841.