How To Use CPT Code 22843

CPT code 22843 describes the placement of posterior segmental instrumentation across seven to twelve vertebral segments during a spinal surgery. 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 22843?

CPT 22843 is used to describe the placement of posterior segmental instrumentation across seven to twelve vertebral segments during a spinal surgery. This code is used when a provider uses pedicle fixation, dual rods with multiple hooks and sublaminar wires to correct a spinal deformity. It is important to note that CPT 22843 should be used in conjunction with the primary procedure code for the spinal surgery.

2. Official Description

The official description of CPT code 22843 is: ‘Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires) 7 to 12 vertebral segments (List separately in addition to code for primary procedure).’ This code should be used in conjunction with the primary procedure code for the spinal surgery.

3. Procedure

During the placement of posterior segmental instrumentation (CPT 22843), the provider performs the following steps:

1. The provider identifies the target segments and detaches surrounding tissues and ligaments.
2. Using imaging guidance, the provider drills the posterior cortex directly posterior to the pedicle.
3. The provider enters the pedicle and places screws through the pedicle into the vertebral body on each side of each vertebra to be segmentally fixed.
4. Hooks and clamps may be applied near transverse processes and laminae at the chosen vertebrae.
5. The provider bends the rod or plate to achieve the desired shape for the spine and attaches it to the segmental fixation at each segment with nuts or screws.
6. The provider checks the alignment on imaging.
7. The provider then continues with the primary procedure to completion and closes the wound.

4. Qualifying circumstances

CPT 22843 is performed on patients who require correction of a spinal deformity through the placement of posterior segmental instrumentation. This code is used when the provider places pedicle fixation, dual rods with multiple hooks and sublaminar wires across seven to twelve vertebral segments. It is important to note that CPT 22843 should be reported in conjunction with the primary procedure code for the spinal surgery.

5. When to use CPT code 22843

CPT code 22843 should be used when a provider performs the placement of posterior segmental instrumentation across seven to twelve vertebral segments during a spinal surgery. It is important to report this code in addition to the primary procedure code for the spinal surgery.

6. Documentation requirements

To support a claim for CPT 22843, the provider must document the following information:

• Documentation of the primary procedure for the spinal surgery
• Documentation of the placement of posterior segmental instrumentation across seven to twelve vertebral segments
• Details of the specific instrumentation used, such as pedicle fixation, dual rods, hooks, and sublaminar wires
• Documentation of the number of vertebral segments involved
• Imaging guidance used during the procedure
• Documentation of the alignment of the instrumentation on imaging
• Documentation of the closure of the wound

7. Billing guidelines

When billing for CPT 22843, it is important to ensure that the procedure is performed as described in the official description. This code should be reported in addition to the primary procedure code for the spinal surgery. It is important to note that CPT 22843 should not be reported if the primary procedure code falls within the inpatient only (IPO) list. Additionally, be aware of any specific billing guidelines provided by payers.

8. Historical information

CPT 22843 was added to the Current Procedural Terminology system on January 1, 1996. There have been several historical changes to the code, including code changes in 2008 and Medicare changes in 2017 and 2022.

9. Examples

1. A patient undergoes a spinal fusion surgery, and the provider places posterior segmental instrumentation across eight vertebral segments to correct a spinal deformity.
2. During a spinal surgery, the provider places posterior segmental instrumentation across ten vertebral segments using pedicle fixation, dual rods, and sublaminar wires.
3. A patient with scoliosis undergoes a spinal fusion surgery, and the provider places posterior segmental instrumentation across twelve vertebral segments to correct the spinal deformity.
4. During a spinal surgery, the provider places posterior segmental instrumentation across seven vertebral segments using pedicle fixation and multiple hooks.
5. A patient with kyphosis undergoes a spinal fusion surgery, and the provider places posterior segmental instrumentation across nine vertebral segments to correct the spinal deformity.
6. During a spinal surgery, the provider places posterior segmental instrumentation across eleven vertebral segments using pedicle fixation, dual rods, and sublaminar wires.
7. A patient with a spinal deformity undergoes a spinal fusion surgery, and the provider places posterior segmental instrumentation across twelve vertebral segments to correct the deformity.
8. During a spinal surgery, the provider places posterior segmental instrumentation across seven vertebral segments using pedicle fixation and multiple hooks.
9. A patient with scoliosis undergoes a spinal fusion surgery, and the provider places posterior segmental instrumentation across ten vertebral segments to correct the spinal deformity.
10. During a spinal surgery, the provider places posterior segmental instrumentation across eight vertebral segments using pedicle fixation, dual rods, and sublaminar wires.