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The procedure described by CPT® Code 0221T involves the placement of a posterior intrafacet implant in the lumbar region of the spine. The facet joints, which are the paired posterior vertebral joints located between adjacent vertebrae, play a crucial role in providing stability and facilitating movement of the spine. These joints can become damaged due to various conditions, leading to nerve compression and significant back pain. The placement of an intrafacet implant aims to alleviate these issues by stabilizing the affected vertebral segment. During the procedure, an incision is made over the targeted area of the back, allowing access to the facet joints. Imaging guidance is utilized to enhance visualization of the joint structures, ensuring precise placement of the implant. The procedure may involve the division of the intervertebral ligament and excision of part or all of the lamina to expose the involved nerve root. Once the facet joints are explored, a posterior intrafacet implant, which may include devices such as facet screws or locking screw and nut systems, is inserted to stabilize the spine. If necessary, a bone graft is harvested and placed between the facets to promote healing and stability. The procedure can be performed unilaterally or bilaterally, depending on the extent of the damage. After the implant is placed, measures are taken to control bleeding, and the surgical site is closed. This procedure is specifically indicated for single-level interventions in the lumbar spine, distinguishing it from similar procedures in the cervical and thoracic regions, which are coded differently.
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The placement of a posterior intrafacet implant is indicated for patients experiencing issues related to the facet joints, particularly when these joints have become damaged, leading to nerve compression and back pain. The following conditions may warrant this procedure:
The procedure for the placement of a posterior intrafacet implant involves several critical steps to ensure successful stabilization of the lumbar spine:
After the placement of the posterior intrafacet implant, patients may require monitoring for any complications related to the surgery. Expected recovery may involve pain management and physical therapy to aid in rehabilitation. The surgical site should be kept clean and dry, and patients are typically advised to follow specific post-operative care instructions provided by their healthcare provider. Follow-up appointments will be necessary to assess the healing process and the effectiveness of the implant in alleviating symptoms.
| Short Descr | PLMT POST FACET IMPLT LUMB | Medium Descr | PLMT POST FACET IMPLT UNI/BI W/IMG & GRFT LUMB | Long Descr | Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; lumbar | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 9 - Other Medical Items or Services | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 164 - Other OR therapeutic procedures on musculoskeletal system |
This is a primary code that can be used with these additional add-on codes.
| 0222T | Addon Code MPFS Status: Carrier Priced APC N Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; each additional vertebral segment (List separately in addition to code for primary procedure) |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 74 | Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2017-01-01 | Changed | Guideline changed. |
| 2011-01-01 | Added | First appearance in code book. |
| 2010-01-01 | Added | Code implemented. |
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