How To Use CPT Code 22849

CPT code 22849 describes the reinsertion of a spinal fixation device due to failure of the device or one of its components. 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 22849?

CPT 22849 is used to report the reinsertion of a spinal fixation device when the device or one of its components has failed. This code is used when the provider removes the faulty component and replaces it, or removes the entire device and replaces it with a new one, using the same attachment sites. The procedure involves making a midline incision at the back, exposing the target vertebral segment, and performing the necessary reinsertion.

2. Official Description

The official description of CPT code 22849 is: ‘Reinsertion of spinal fixation device due to failure of the device or one of its components.’

3. Procedure

When performing the reinsertion of a spinal fixation device, the provider follows a specific procedure:

1. The patient is appropriately prepped and anesthetized.
2. A midline incision is made at the back to expose the target vertebral segment.
3. The faulty component, such as a screw or wire, is removed.
4. The provider replaces the faulty component or removes the entire device and replaces it with a new one, using the same attachment sites.
5. The area is irrigated, bleeding is checked, instruments are removed, and the incision is closed.

4. Qualifying circumstances

CPT 22849 is used when there is a failure of the spinal fixation device or one of its components. This may include issues such as loosening, breakage, or displacement of screws, wires, plates, rods, or other hardware used for spinal fixation. The reinsertion procedure is performed to address these complications and ensure the stability and functionality of the spinal fixation.

5. When to use CPT code 22849

CPT code 22849 should be used when the provider performs the reinsertion of a spinal fixation device due to failure of the device or one of its components. It is important to accurately document the reason for the reinsertion and ensure that the procedure aligns with the official description of the code.

6. Documentation requirements

To support a claim for CPT 22849, the provider must document the following information:

• Reason for the reinsertion, specifying the failure of the device or component
• Details of the procedure, including the specific components replaced or the entire device removed and replaced
• Date of the procedure
• Incision site and approach used
• Any complications encountered during the procedure
• Postoperative care instructions, if applicable
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 22849, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the reason for the reinsertion and provide the necessary supporting documentation. Additionally, be aware of any specific billing guidelines or modifiers required by payers for spinal instrumentation services.

8. Historical information

CPT 22849 was added to the Current Procedural Terminology system on January 1, 1990. There have been several updates and changes to the code over the years, including being added and removed from the Inpatient Only (IPO) list for Medicare. It is important to stay updated with the latest coding guidelines and changes related to CPT 22849.

9. Examples

1. A patient undergoes reinsertion of a spinal fixation device due to loosening of screws in the lumbar region.
2. A provider performs the reinsertion of a spinal fixation device after the breakage of a rod used for stabilization in the thoracic spine.
3. A patient requires the replacement of a faulty plate used for spinal fixation in the cervical region.
4. A provider removes and replaces an entire spinal fixation device due to displacement of hooks in the lumbar region.
5. A patient undergoes reinsertion of a spinal fixation device after the failure of wires used for stabilization in the thoracic spine.
6. A provider performs the reinsertion of a spinal fixation device due to the loosening of screws in the cervical region.
7. A patient requires the replacement of a faulty rod used for spinal fixation in the lumbar region.
8. A provider removes and replaces an entire spinal fixation device due to the breakage of a plate used for stabilization in the thoracic spine.
9. A patient undergoes reinsertion of a spinal fixation device after the displacement of screws in the cervical region.
10. A provider performs the reinsertion of a spinal fixation device due to the failure of cables used for stabilization in the lumbar region.