CPT® Code 22212

An osteotomy of the spine is a surgical procedure that involves the removal of a portion of a vertebra to correct spinal deformities, such as a flexion deformity. This procedure is performed using a posterior or posterolateral approach, which means that the incision is made either directly over the affected vertebral segment or just to the side of it. The goal of the osteotomy is to realign the vertebral segment, thereby improving the overall function and stability of the spine while also alleviating pain associated with the deformity. During the procedure, the fascia is incised, and a subperiosteal dissection is carried out along the spinal process, lamina, transverse processes, and rib head of the vertebral segment as necessary. A wedge of bone is then resected, which may involve the removal of parts of the supraspinatus and infraspinatus ligaments and spinous processes. The surgeon carefully repositions the patient and applies manual pressure at the osteotomy site to facilitate the tearing of opposing ligaments, all while ensuring that nerve roots and other critical structures are visible and protected from any potential impingement. After the bony gap created by the wedge resection is closed, additional stabilization may be achieved through separately reportable bone grafts and/or spinal instrumentation. To ensure proper healing and immobilization of the spine, a body cast or jacket may be applied post-operatively. This procedure is specifically coded as CPT® 22212 for the osteotomy of one thoracic vertebral segment, with related codes available for cervical and lumbar segments as well as for additional vertebral segments.