CPT® Code 22634

Add-On Code

Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (List separately in addition to code for primary procedure)

The procedure described by CPT® Code 22634 refers to arthrodesis, which is a surgical technique aimed at fusing one or more lumbar vertebral joints. This procedure is typically indicated for treating conditions such as fractures or instability within the lumbar spine. The fusion is achieved using a combined posterior or posterolateral technique alongside a posterior interbody technique. The surgical approach involves making an incision in the lower back to access the affected lumbar vertebral joint(s). During the procedure, soft tissues are carefully dissected to expose the vertebrae, allowing for the removal of part of the lamina using a bone drill. The intervertebral disc is excised, and the joint space is meticulously prepared for the arthrodesis. In addition to the primary fusion, the procedure may involve other separately reportable interventions, such as fracture treatment or decompression, as necessary. The preparation for fusion includes addressing the transverse processes, facet joints, and/or laminae to facilitate the placement of a bone graft. This graft can be harvested from the iliac crest or another site, and allograft bone from a bone bank may also be utilized. The graft is strategically placed in the intervertebral joint space to promote the fusion of the vertebral bodies. Additional graft material may be applied to other areas of the vertebral joint, including the transverse processes, facet joints, or laminae, to ensure a successful fusion. To stabilize the joint, drill holes are created in the facets or spinous processes of each vertebra, and wires are threaded through the vertebrae. Alternatively, other internal fixation devices, which are separately reportable, may be inserted through the pedicles or facets. After the necessary procedures are completed, a drain may be placed, and the surgical wound is closed in layers. It is important to note that CPT® Code 22634 is specifically used for reporting the fusion of each additional interspace and vertebral segment, while CPT® Code 22633 is designated for the fusion of a single interspace of the lumbar spine.