CPT® Code 22216

Add-On Code

Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately in addition to primary procedure)

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 aims to realign the affected vertebral segment, thereby improving the overall function and stability of the spine while alleviating associated pain. The surgery is performed using a posterior or posterolateral approach, which entails making an incision directly over the affected vertebral segment or just lateral to it. This approach allows for direct access to the vertebra while minimizing damage to surrounding tissues.

During the procedure, the fascia is incised, and a subperiosteal dissection is conducted along the spinal process, lamina, and both transverse processes, as well as the rib head of the vertebral segment, as necessary. A wedge of bone is then resected, which may involve excising portions of the supraspinatus and infraspinatus ligaments and spinous processes. The surgeon carefully repositions the patient and applies manual pressure at the osteotomy site until the opposing ligaments tear, ensuring that nerve roots and other vital structures are kept under direct visualization to prevent any impingement during the manipulation of the vertebra. Once the bony gap created by the wedge resection is closed, additional stabilization methods, such as separately reportable bone grafts and/or spinal instrumentation, may be employed. To ensure proper healing and immobilization of the spine, a body cast or jacket may be applied as needed. This procedure is coded as CPT® 22216 for each additional vertebral segment after the first, with specific codes designated for osteotomies of one cervical, thoracic, or lumbar segment.