Summary & Overview
CPT 22222: Thoracic Vertebral Osteotomy with Disk Excision
CPT code 22222 represents a thoracic vertebral osteotomy with excision of adjacent disk material to correct abnormal curvature of the upper spine. This is a major corrective spine surgery used to treat deformities such as structural thoracic kyphosis or other sagittal or coronal plane malalignment that require bone resection and disk removal to restore alignment. The code matters nationally because it corresponds to high-acuity inpatient surgical care with significant resource utilization, perioperative risk, and implications for surgical quality measurement.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing context for the procedure, an overview of typical sites of service and service type, and guidance on what to expect in analyses of utilization and reimbursement patterns. The publication summarizes benchmark considerations, payer coverage scope, and policy factors that commonly affect payment and prior authorization practices for complex spine procedures. Data not available in the input is clearly noted where applicable.
Billing Code Overview
CPT code 22222 describes a surgical procedure in which the provider incises a vertebra to remove portions of bone and excises adjoining disk material to correct an abnormal curvature in the thoracic spine. This operation alters vertebral alignment and removes deforming elements of the vertebra and disk to address spinal deformity.
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Service type: Corrective thoracic spine surgery involving vertebral osteotomy and disk excision
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Typical site of service: Inpatient hospital or specialized surgical center where spine surgeries are performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent or young adult presenting with progressive thoracic spinal curvature (kyphoscoliosis) causing pain, pulmonary compromise, or cosmetic concern refractory to conservative management. The patient has undergone full preoperative evaluation including standing scoliosis radiographs, MRI to assess neural elements and disk pathology, pulmonary function testing, and routine pre-anesthesia assessment. The surgical plan is a thoracic posterior or anterior approach osteotomy and disk excision to correct spinal alignment; intraoperative neuromonitoring and fluoroscopy are employed. The workflow includes preoperative clearance, anesthesia induction, positioning in prone or lateral decubitus depending on approach, exposure of the affected vertebrae, performance of the osteotomy (incising and removing portions of the vertebral body and adjacent disk material), deformity correction with instrumentation and fusion as indicated, hemostasis, closure, and postoperative monitoring in PACU with planned inpatient admission for pain control, neurologic checks, and physical therapy initiation. Typical sites of service are the operating room within a hospital inpatient setting or an ambulatory surgery center when appropriate for limited procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When two surgeons of different specialties perform distinct portions of the osteotomy and correction concurrently. |