Insights into Posterior, Posterolateral, or Lateral Transverse Process Technique

For reporting instrumentation procedures, please refer to 22840-22855 and 22859. Please report the definitive procedures with their respective codes. However, it is important not to append modifier 62 to spinal instrumentation codes 22840-22848, 22850, 22852, 22853, 22854, and 22859.

For reporting bone graft procedures, please refer to 20930-20938. Please report the definitive procedures with their respective codes. However, it is important not to append modifier 62 to bone graft codes 20900-20938.

Corpectomy: This text appears to be clear and error-free. It reads “Identifies the removal of a vertebral body during spinal surgery.”

Facetectomy: The facet joint between two vertebral bodies may be excised. Each vertebral segment contains two facet joints.

Foraminotomy: The intervertebral foramen is widened by removing a piece of bone between the superior notch of the adjacent vertebra, the inferior notch of the vertebra, the facet joint, and the border of the intervertebral disc.

Hemilaminectomy: Removal of a portion of the vertebral lamina is typically performed to explore, access, or decompress the intraspinal contents.

Laminotomy: Excision of a portion of the vertebral lamina to relieve pressure on a spinal nerve root by enlarging the intervertebral foramen.

A vertebral segment describes the constituent part into which the spine may be divided. It represents a single complete vertebral bone with its associated articular processes and laminae. A vertebral interspace is the non-bony compartment between two adjacent vertebral bodies which contains the intervertebral disc and includes the nucleus pulposus, annulus fibrosus, and two cartilaginous endplates.

Decompression performed on the same vertebral segment(s) and interspace(s) as posterior lumbar interbody fusion that includes laminectomy, facetectomy, or foraminotomy may be separately reported using 63052, 63053.

CPT Code 22590 Arthrodesis, posterior technique, craniocervical (occiput- C2)

CPT Code 22595 Arthrodesis, posterior technique, atlas-axis (C1-C2)
CPT Code 22600 Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment

CPT Code 22610 thoracic (with lateral transverse technique, when performed)
CPT Code 22612 lumbar (with lateral transverse technique, when performed)
(Do not report 22612 in conjunction with 22630 for the same interspace; use 22633)

CPT Code 22614 each additional interspace (List separately in addition to code for primary procedure)

(It is recommended to use 22614 together with any of the following numbers – 22600, 22610, 22612, 22630, or 22633 when performing arthrodesis at a different interspace. In case of performing a posterior or posterolateral technique for fusion/arthrodesis at an additional interspace, use 22614. For performing a posterior interbody fusion arthrodesis at an additional interspace, use 22632. When performing a combined posterior or posterolateral technique with posterior interbody arthrodesis at an additional interspace, use 22634.)

CPT Code 22630 Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar

(Do not report 22630 in conjunction with 22612 for the same interspace and segment, use 22633)

CPT Code 22632 for each additional interspace (List separately in addition to code for primary procedure)

(“When performing a fusion/arthrodesis procedure at a different interspace, you may use 22632 in combination with 22612, 22630, or 22633. If you are performing a posterior interbody fusion arthrodesis at an additional interspace, then 22632 is recommended. For a posterior or posterolateral technique for fusion/arthrodesis at an extra interspace, you should use 22614. In case of a combined posterior or posterolateral technique with posterior interbody arthrodesis at an additional interspace, 22634 is suggested.”)

(Do not report 22630, 22632 in conjunction with 63030, 63040, 63042, 63047, 63052, 63053, 63056, for laminectomy performed to prepare the interspace on the same spinal interspace[s].

CPT Code  22633 Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace; lumbar

CPT Code 22634 Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), each additional interspace and segment (List separately in addition to code for primary procedure)

(If decompression is performed on the same area where posterior interbody fusion is done, which includes laminectomy, removal of facets, and/or widening of the foramen to relieve pressure on the nerves or spinal components like the spinal cord, cauda equina, or nerve roots, then please refer to 63052, 63053. refer to 63052, 63053.)

Example for Occiput to C2 Fusion

A patient with severe instability in the craniocervical junction due to congenital abnormalities or acquired injuries causes neurological symptoms such as pain, weakness, or mobility difficulties.

Procedure Description: Surgeons use a posterior approach to perform an arthrodesis, which involves making incisions in the posterior region of the neck and upper back. Through this approach, the surgeon accesses the craniocervical junction and stabilizes it using various techniques such as bone grafting, instrumentation (like screws and rods), and fusion methods to immobilize the occiput and C2 vertebra and promote fusion between them.

After the surgery, the patient undergoes a recovery period, which usually involves immobilization using a cervical collar or brace. Physical therapy is gradually initiated to help the patient regain strength and mobility while allowing the fused region to heal properly.

The goal of the surgery is to stabilize the craniocervical junction, relieve symptoms, prevent further damage, and restore as much function as possible, thereby improving the patient’s quality of life.

The CPT code 22590 describes a complex surgical procedure that involves the fusion of critical spinal structures in the upper cervical spine to address instability or pathology in the craniocervical region.

Example for  Lumbar Interbody Fusion with Posterior Technique

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