CPT® Code 22844

Add-On Code

Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more 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 primarily employed to address deformities or instabilities within the spine. The instrumentation involves the attachment of fixation devices to the upper and lower vertebral segments, as well as at least one additional vertebral segment situated between them. The fixation methods can vary, including pedicle fixation, which is also known as transpedicular fixation, and dual rod fixation that incorporates 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 subsequently secured to a plate or other stabilizing device to enhance spinal stability. Alternatively, in dual rod fixation, rods are positioned on either side of the affected spinal area and are affixed to each vertebral segment using hooks and/or sublaminar wires. The hooks can be attached to either the pedicle or the lamina of the vertebrae. When sublaminar wires are utilized, they are looped under the lamina of each vertebral segment and then wrapped around the rods, where they are tightened to secure the instrumentation. This procedure is specifically coded as CPT® 22844 when it involves 13 or more vertebral segments, distinguishing it from other codes that apply to fewer segments.