CPT® Code 22843

Add-On Code

Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)

Posterior segmental spinal instrumentation is a surgical procedure utilized during a separately reportable arthrodesis, commonly known as spinal fusion. This technique is essential for addressing deformities or instabilities within the spine, providing the necessary support and alignment. The instrumentation involves the attachment of fixation devices to both the upper and lower vertebral segments, as well as at least one additional vertebral segment situated between them. The primary methods of fixation include pedicle fixation and dual rod fixation, which utilize multiple hooks and sublaminar wires. In pedicle fixation, screws are inserted in a posteroanteromedial direction through the pedicle and into the vertebral body, spanning across two or more interspaces, which means it engages three or more vertebrae. These screws are then secured to a plate or other stabilizing device to ensure the spine's stability. Alternatively, dual rod fixation involves placing rods on either side of the affected spinal area, which are then anchored to each vertebral segment using hooks and/or sublaminar wires. The hooks can be affixed to either the pedicle or the lamina of the vertebrae. When sublaminar wires are employed, they are looped under the lamina of each vertebral segment and tightened around the rods, further enhancing the stability of the spinal structure. This procedure is categorized based on the number of vertebral segments involved, with specific codes assigned for different ranges: CPT® Code 22842 for 3 to 6 segments, CPT® Code 22843 for 7 to 12 segments, and CPT® Code 22844 for 13 or more segments.