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Medicare Advantage Musculoskeletal Procedure and Pain Management Codes

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Medicare Advantage Musculoskeletal Procedure and Pain Management Codes Medicare Advantage Musculoskeletal Procedure and Pain Management Codes CPT® Description 20560 General introduction or removal procedures on the musculoskeletal system 20561 General introduction or removal procedures on the musculoskeletal system Partial excision of posterior vertebral component (e.g., spinous process, lamina or facet) 22100 for intrinsic bony lesion, single vertebral segment; cervical Partial excision of posterior vertebral component (e.g., spinous process, lamina or facet) 22101 for intrinsic bony lesion, single vertebral segment; thoracic Partial excision of posterior vertebral component (e.g., spinous process, lamina or facet) 22102 for intrinsic bony lesion, single vertebral segment; lumbar Partial excision of posterior vertebral component (e.g., spinous process, lamina or 22103 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 decompression of 22110 spinal cord or nerve root(s), single vertebral segment; cervical Partial excision of vertebral body, for intrinsic bony lesion, without decompression of 22112 spinal cord or nerve root(s), single vertebral segment; thoracic Partial excision of vertebral body, for intrinsic bony lesion, without decompression of 22114 spinal cord or nerve root(s), single vertebral segment; lumbar each additional vertebral segment (list separately in addition to code for primary 22116 procedure) Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral 22206 segment (e.g., pedicle/vertebral body subtraction); thoracic Osteotomy of spine, posterior approach, 3 columns, 1 vertebral segment (e.g., Pedicle/ 22207 vertebral body subtraction); lumbar Pain Management Spine Surgery Joint Surgery Physical Medicine 11 CPT® Description Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral 22208 segment (e.g., pedicle/vertebral body subtraction); each additional vertebral segment (list separately in addition to code for primary procedure) Osteotomy of spine, posterior or posterolateral approach, one vertebral segment; 22210 cervical 22212 Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic 22214 Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar each additional vertebral segment (list separately in addition to code for primary 22216 procedure) Osteotomy of spine, including discectomy anterior approach, single vertebral segment; 22220 cervical Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; 22222 thoracic Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; 22224 lumbar Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; 22226 each additional vertebral segment (List separately in addition to code for primary procedure Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, 22510 unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, 22511 unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional 22512 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 mechanical device (e.g., kyphoplasty), 22513 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 mechanical device (e.g., kyphoplasty), 22514 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar Pain Management Spine Surgery Joint Surgery Physical Medicine 2 CPT® Description Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 22515 1 vertebral body, unilateral or 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 discectomy to prepare 22532 interspace (other than for decompression); thoracic Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare 22533 interspace (other than for decompression); lumbar Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare 22534 interspace (other than for decompression); 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 (atlas-axis), with or 22548 without excision of odontoid process Arthrodesis, anterior interbody, including disc space preparation, discectomy, 22551 osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 Arthrodesis, anterior interbody, including disc space preparation, discectomy, 22552 osteophytectomy and decompression of spinal cord Arthrodesis, anterior interbody technique, including minimal discectomy to prepare 22554 interspace (other than for decompression); cervical below C2 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare 22556 interspace (other than for decompression); thoracic Arthrodesis, anterior interbody technique, including minimal discectomy to prepare 22558 interspace (other than for decompression); lumbar Arthrodesis, anterior interbody technique, including minimal discectomy to prepare 22585 interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure) Arthrodesis, pre-sacral interbody technique, including disc space preparation, 22586 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; cervical below C2 22600 segment Arthrodesis, posterior or posterolateral technique, single level; thoracic (with or without 22610 lateral transverse technique) Pain Management Spine Surgery Joint Surgery Physical Medicine 3 CPT® Description Arthrodesis, posterior or posterolateral technique, single level; lumbar (with or without 22612 lateral transverse technique) Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral 22614 segment (List separately in addition to code for primary procedure) Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to 22630 prepare interspace (other than for decompression), single interspace; lumbar Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy 22632 to prepare interspace (other than for decompression), single interspace; each additional interspace (List separately in addition to code for primary procedure) Arthrodesis, combined posterior or posterolateral technique with posterior interbody 22633 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 22634 (other than for 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 6 vertebral 22800 segments Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral 22802 segments Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral 22804 segments Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral 22808 segments Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral 22810 segments Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral 22812 segments Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) 22818 (including body and posterior elements); single or 2 segments Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) 22819 (including body and posterior elements); 3 or more segments 22830 Exploration of spinal fusion Posterior non-segmental instrumentation (e.g., Harrington rod technique, pedicle 22840 fixation across 1 interspace, atlantoaxial 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 separately in addition to 22841 code for primary procedure) Pain Management Spine Surgery Joint Surgery Physical Medicine 4 CPT® Description Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with
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