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The procedure described by CPT® Code 0222T involves the placement of a posterior intrafacet implant, which can be performed unilaterally or bilaterally. This procedure is specifically aimed at addressing issues related to the facet joints, which are the paired posterior vertebral joints located between the vertebrae of each segment of the spine. These joints play a crucial role in providing stability and facilitating movement between adjacent vertebrae. When the intervertebral disc sustains damage, the facet joints can become compromised, leading to conditions such as nerve compression and significant back pain. The surgical intervention begins with an incision over the affected vertebral segment, allowing for direct access to the facet joints. Imaging guidance is utilized to enhance visualization during the procedure, ensuring precision in the placement of the implant. The intervertebral ligament is divided to expose the lamina, which may require partial or complete excision to reveal the involved nerve root. Following exploration of the facet joints, stabilization is achieved through the insertion of a posterior intrafacet implant, which may include devices such as a facet screw system or a locking screw and nut device. In cases where a bone graft is necessary, it can be harvested from the local area or from the iliac crest, prepared, and placed between the facets. Additionally, bone cement may be injected to further secure the implant. This procedure can be performed on one side or both sides of the paired facet joints, depending on the clinical need. Upon completion, meticulous attention is given to controlling any bleeding, irrigating the wound, and closing the incisions to promote optimal healing.
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The placement of a posterior intrafacet implant is indicated for patients experiencing issues related to the facet joints, which may include:
The procedure for the placement of a posterior intrafacet implant involves several critical steps, which are detailed as follows:
Post-procedure care involves monitoring the patient for any complications and ensuring proper recovery. Patients may be advised on pain management strategies and rehabilitation exercises to facilitate healing. Follow-up appointments are essential to assess the success of the implant placement and to monitor for any signs of complications, such as infection or implant failure. The healthcare provider will provide specific instructions regarding activity restrictions and any necessary physical therapy to support recovery.
| Short Descr | PLMT POST FACET IMPLT ADDL | Medium Descr | PLACE POSTERIOR INTRAFACET IMPLANT ADDL SEGMENT | 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; each additional vertebral segment (List separately in addition to code for primary procedure) | Status Code | Carriers Price the Code | Global Days | ZZZ - Code Related to Another Service | 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 | Items and Services Packaged into APC Rates | 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 an add-on code that must be used in conjunction with one of these primary codes.
| 0219T | MPFS Status: Carrier Priced APC C Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical | 0220T | MPFS Status: Carrier Priced APC C Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; thoracic | 0221T | MPFS Status: Carrier Priced APC J1 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 |
| 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. | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2011-01-01 | Added | First appearance in code book. |
| 2010-01-01 | Added | Code implemented. |
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