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Commercial Musculoskeletal Codes Updated January 2018 Commercial Musculoskeletal Codes Investigational or Non-Covered Spine Surgery Pain Management Joint Surgery Codes associated with an Arthrogram CPT Description Commercial Notes Partial excision of posterior vertebral component (eg, spinous 22100 process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical 22101 Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic 22102 Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar Partial excision of posterior vertebral component (eg, spinous process, 22103 lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (List separately in addition to code for primary procedure) Partial excision of vertebral body, for intrinsic bony lesion, without 22110 decompression of spinal cord or nerve root(s), single vertebral segment;cervical Partial excision of vertebral body, for intrinsic bony lesion, without 22112 decompression of spinal cord or nerve root(s), single vertebral segment; thoracic Partial excision of vertebral body, for intrinsic bony lesion, without 22114 decompression of spinal cord or nerve root(s), single vertebral segment; lumbar each additional vertebral segment (list separately in addition to code 22116 for primary procedure) Osteotomy of spine, posterior or posterolateral approach, 3 columns, 22206 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracic Osteotomy of spine, posterior approach, 3 columns, 1 vertebral 22207 segment (eg. Pedicle/vertebral body subtraction);lumbar Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); each 22208 additional vertebral segment (list separately in addition to code for primary procedure) Osteotomy of spine, posterior or posterolateral approach, one 22210 vertebral segment; cervical Osteotomy of spine, posterior or posterolateral approach, 1 vertebral 22212 segment; thoracic Osteotomy of spine, posterior or posterolateral approach, 1 vertebral 22214 segment; lumbar each additional vertebral segment (list separately in addition to code 22216 for primary procedure) Osteotomy of spine, including discectomy anterior approach, single 22220 vertebral segment; cervical Osteotomy of spine, including discectomy, anterior approach, single 22222 vertebral segment; thoracic Osteotomy of spine, including discectomy, anterior approach, single 22224 vertebral segment; lumbar Updated January 2018 Osteotomy of spine, including discectomy, anterior approach, single 22226 vertebral segment; each additional vertebral segment (List separately in addition to code for primary procedure Percutaneous vertebroplasty (bone biopsy included when 22510 performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic Percutaneous vertebroplasty (bone biopsy included when 22511 performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, 22512 inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure) Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using 22513 mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using 22514 mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or 22515 bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure) Arthrodesis, lateral extracavitary technique, including minimal 22532 discectomy to prepare interspace (other than for decompression); thoracic Arthrodesis, lateral extracavitary technique, including minimal 22533 discectomy to prepare interspace (other than for decompression); lumbar Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); 22534 thoracic or lumbar, each additional vertebral segment (List separately in addition to code for primary procedure) Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 22548 (atlas-axis), with or without excision of odontoid process Arthrodesis, anterior interbody, including disc space preparation, 22551 discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 Arthrodesis, anterior interbody, including disc space prep, 22552 discectomy, osteophytectomy + decompression of spinal cord a Arthrodesis, anterior interbody technique, including minimal 22554 discectomy to prepare interspace (other than for decompression); cervical below C2 Arthrodesis, anterior interbody technique, including minimal 22556 discectomy to prepare interspace (other than for decompression); thoracic Arthrodesis, anterior interbody technique, including minimal 22558 discectomy to prepare interspace (other than for decompression); lumbar Updated January 2018 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); 22585 each additional interspace (List separately in addition to code for primary procedure) Arthrodesis, pre-sacral interbody technique, including disc space 22586 preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspace 22590 Arthrodesis, posterior technique, craniocervical (occiput-C2) 22595 Arthrodesis, posterior technique, atlas-axis (C1-C2) Arthrodesis, posterior or posterolateral technique, single level; 22600 cervical below C2 segment Arthrodesis, posterior or posterolateral technique, single level; 22610 thoracic (with or without lateral transverse technique) Arthrodesis, posterior or posterolateral technique, single level; 22612 lumbar (with or without lateral transverse technique) Arthrodesis, posterior or posterolateral technique, single level; each 22614 additional vertebral segment (List separately in addition to code for primary procedure) Arthrodesis, posterior interbody technique, including laminectomy 22630 and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for 22632 decompression), single interspace; each additional interspace (List separately in addition to code for primary procedure) Arthrodesis, combined posterior or posterolateral technique with 22633 posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for 22634 decompression), single interspace and segment; each additional interspace and segment (List separately in addition to code for primary procedure) Arthrodesis, posterior, for spinal deformity, with or without cast; up to 22800 6 vertebral segments Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 22802 12 vertebral segments Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or 22804 more vertebral segments Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 22808 vertebral segments Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 22810 vertebral segments Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or 22812 more vertebral segments Kyphectomy, circumferential exposure of spine and resection of 22818 vertebral segment(s) (including body and posterior elements); single or 2 segments Kyphectomy, circumferential exposure of spine and resection of 22819 vertebral segment(s) (including body and posterior elements); 3 or more segments 22830 Exploration of spinal fusion Updated January 2018 Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial 22840 transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure) Internal spinal fixation by wiring of spinous processes (List 22841 separately in addition to code for primary procedure) Posterior segmental instrumentation (eg, pedicle fixation, dual rods 22842 with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure) Posterior segmental instrumentation (eg, pedicle fixation, dual rods 22843 with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure) Posterior
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