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The CPT® Code 22112 refers to the procedure of partial excision of a vertebral body specifically for the treatment of an intrinsic bony lesion located within a single thoracic vertebral segment. This procedure is performed without the need for decompression of the spinal cord or nerve roots, indicating that the primary focus is on the removal of the bony lesion itself rather than addressing any potential compression issues affecting the spinal structures. During the procedure, a surgical incision is made over the affected vertebral segment or just lateral to the vertebra in question. The paravertebral muscles are then carefully exposed, either by incision or retraction, to allow access to the vertebral body. Once the vertebral body is exposed, the surgeon locates the lesion and evaluates its extent through visual inspection and, if necessary, radiographic imaging. The surgeon meticulously maps out the area of bone that needs to be removed to ensure complete excision of the lesion while safeguarding surrounding nerve roots and other critical structures. The actual removal of the bony lesion is accomplished using specialized instruments such as a high-speed bur and/or curette. After the lesion has been completely excised, the surgical incision is closed in layers to promote proper healing. This procedure is distinct from other related codes, such as 22110 for cervical vertebral body lesions, 22214 for lumbar vertebral body lesions, and 22116 for excisions involving additional vertebral bodies beyond the first.
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The procedure represented by CPT® Code 22112 is indicated for the removal of intrinsic bony lesions located within a single thoracic vertebral segment. These lesions may present as tumors or other abnormal growths that necessitate surgical intervention to alleviate potential complications or to obtain a biopsy for further analysis. The primary goal of this procedure is to excise the lesion while preserving the integrity of the spinal cord and nerve roots, which is crucial for maintaining neurological function.
The procedure begins with the surgeon making an incision over the affected thoracic vertebral segment or just lateral to the vertebra. This incision allows for access to the paravertebral muscles, which are then either incised or retracted to expose the vertebral body. Once the vertebral body is visible, the surgeon locates the bony lesion. To assess the extent of the lesion, the surgeon may utilize visual inspection and radiographic imaging as needed. After determining the size and location of the lesion, the surgeon carefully maps out the area of bone that needs to be excised. The removal of the bony lesion is performed using a high-speed bur and/or curette, ensuring that care is taken to protect the surrounding nerve roots and other vital structures during the excision. Once the lesion has been completely removed, the surgical incision is closed in layers to facilitate proper healing and recovery.
Post-procedure care following the partial excision of the thoracic vertebral body involves monitoring the patient for any signs of complications, such as infection or excessive bleeding. Patients may be advised to limit physical activity and follow specific rehabilitation protocols to ensure proper healing of the surgical site. Follow-up appointments are typically scheduled to assess recovery and to evaluate the success of the procedure in alleviating symptoms associated with the bony lesion. Additionally, any necessary imaging studies may be performed to confirm the complete removal of the lesion and to monitor the integrity of the surrounding spinal structures.
| Short Descr | REMOVE PART THORAX VERTEBRA | Medium Descr | PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC | Long Descr | Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 142 - Partial excision bone |
This is a primary code that can be used with these additional add-on codes.
| 22116 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (List separately in addition to code for primary procedure) | 22840 | Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure) | 22841 | Addon Code MPFS Status: Bundled Code APC C Physician Quality Reporting CPT Assistant Article Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure) | 22842 | Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure) | 22843 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 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) | 22844 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 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) | 22845 | Addon Code MPFS Status: Active Code APC N ASC N1 Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure) | 22846 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure) | 22847 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure) | 22848 | Addon Code MPFS Status: Active Code APC N Physician Quality Reporting CPT Assistant Article Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure) | 22853 | CPT Add On MPFS Status: Active Code APC N ASC N1 Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure) | 22854 | CPT Add On MPFS Status: Active Code APC N ASC N1 Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure) | 22859 | CPT Add On CPT Resequenced MPFS Status: Active Code APC N ASC N1 Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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