Summary & Overview
CPT 22114: Lumbar Vertebral Body Excision
CPT code 22114 denotes surgical removal of portions of a single lumbar vertebral body to excise a damaged or diseased area without decompression of the spinal cord or nerve roots. This code captures a focused vertebral body excision procedure distinct from laminectomy or other decompressive spine surgeries. Nationally, accurate reporting of this code matters for clinical registries, outcome tracking, and claims adjudication for spine surgery services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical intent of the code, where the procedure is typically performed, and the types of reimbursement and billing considerations commonly associated with operative spine procedures. The publication outlines benchmark topics such as utilization patterns, coding practice implications, and payer coverage considerations at a national level. It also provides clinical context to help distinguish 22114 from decompressive spine codes and other vertebral procedures.
Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 22114 describes the surgical excision of portions of the main body of a single lumbar vertebra to remove a damaged or diseased area contained within that bone. The procedure specifically targets the vertebral body and does not include decompression of the spinal cord or nerve roots.
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Service type: Surgical excision of vertebral body lesion (lumbar)
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Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgical center, depending on clinical complexity and facility capabilities.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a focal osteolytic lesion in the L3 vertebral body presents with localized axial low-back pain and progressive instability on imaging. Prior conservative care failed and imaging (MRI and CT) demonstrates a single-level destructive lesion confined to the main body of the L3 vertebra without compression of the cauda equina or lumbar nerve roots. The surgical team schedules a vertebral body excision (partial corpectomy) of the lumbar vertebra to remove the damaged/diseased bone and obtain tissue for histopathology. The procedure is performed in an operating room under general anesthesia. Typical perioperative workflow includes preoperative imaging review, informed consent documenting that no direct spinal cord or nerve-root decompression is planned, standard intraoperative monitoring as indicated, specimen submission for pathology and culture, possible staged or concurrent stabilization (instrumentation) depending on intraoperative assessment, and postoperative inpatient observation with pain control and mobility evaluation. Billing uses 22114 for excision of portions of the main body of a single lumbar vertebra when no decompression of neural elements is performed. Relevant payors for authorization and claims follow standard commercial and government plans such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services |