CPT® Code 22226

Add-On Code

Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (List separately in addition to code for 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 is performed through an anterior approach, which may involve incisions in the neck, thoracic region, thoracoabdominal area, abdomen, retropleural space, or retroperitoneal space, depending on the specific location of the deformity. The goal of the osteotomy is to realign the affected vertebral segment, thereby improving the overall function and stability of the spine while alleviating associated pain. During the procedure, soft tissues are carefully dissected to expose the vertebrae, and subperiosteal dissection is performed along the vertebral segment as necessary. Accessing the intervertebral disc may require the removal of a portion of the lamina. A curette is then utilized to excise the intervertebral disc or any disc fragments. A wedge of bone is resected from the vertebral body, which may also involve the excision of surrounding ligaments and spinous processes. The surgeon applies manual pressure at the osteotomy site to facilitate realignment, ensuring that nerve roots and other critical structures are protected throughout the process. Once the bony gap created by the wedge resection is closed, additional stabilization may be achieved through the use of bone grafts and/or spinal instrumentation. Post-operatively, a body cast or jacket may be applied to immobilize the spine as needed. This code, CPT® 22226, is specifically used to report each additional vertebral segment involved in the osteotomy procedure, following the primary procedure code for the first segment.