CPT® Code 22220

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 through an anterior approach, which means that the incision is made from the front of the neck. The goal of the osteotomy is to realign the affected vertebral segment, thereby improving the overall function and stability of the spine while alleviating pain associated with the deformity. The surgery may require various types of incisions depending on the specific location and extent of the deformity, including anterior neck, thoracic, thoracoabdominal, abdominal, retropleural, or retroperitoneal approaches. During the procedure, the surgeon carefully dissects the soft tissues to expose the vertebrae, performing subperiosteal dissection along the vertebral segment as necessary. In some cases, a portion of the lamina, which is the bony arch of the vertebra, may be removed to gain access to the intervertebral disc. The intervertebral disc or any fragments are then excised using a curette. A wedge of bone is resected from the vertebral body, which may also involve the removal of surrounding ligaments and spinous processes. To ensure the safety of the patient, the surgeon applies manual pressure at the osteotomy site while carefully repositioning the patient, ensuring that nerve roots and other vital structures are 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 may be achieved through separately reportable bone grafts and/or spinal instrumentation. Post-surgery, a body cast or jacket may be applied to immobilize the spine, facilitating proper healing. This procedure is specifically coded as CPT® Code 22220 for the osteotomy of one cervical vertebral segment, with additional codes available for thoracic and lumbar segments.