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Anterior arthrodesis, commonly known as spinal fusion, is a surgical procedure aimed at correcting spinal deformities, such as kyphosis or scoliosis, by fusing two or more vertebral segments. This procedure is particularly indicated for patients with significant spinal deformities that may cause pain, instability, or functional impairment. The surgery involves making an incision in the anterior (front) part of the body, which may be located in the neck, thoracic region, thoracoabdominal area, abdomen, retropleural space, or retroperitoneal space, depending on the specific location of the deformity. During the procedure, the surgeon carefully dissects the soft tissues to expose the affected vertebrae. The vertebral segments are then prepared for fusion by roughening their surfaces to enhance the integration of the bone graft. A bone graft, which can be autogenous (taken from the patient's own body, such as the ribs or iliac crest) or allograft (from a bone bank), is placed along the prepared vertebrae to facilitate the fusion process. Additionally, internal fixation devices may be utilized to stabilize the vertebrae during the healing process. The surgical site is closed in layers, and a body cast may be applied if necessary to support the spine during recovery. This procedure is specifically coded as CPT® 22812 when it involves the fusion of eight or more vertebral segments.
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Anterior arthrodesis for spinal deformity is indicated for various conditions that affect the alignment and stability of the spine. The following are the explicitly provided indications for this procedure:
The procedure for anterior arthrodesis involves several critical steps to ensure successful fusion of the vertebral segments. The following outlines the procedural steps:
After the anterior arthrodesis procedure, patients can expect a recovery period that may involve monitoring for complications and managing pain. Post-operative care typically includes instructions for activity restrictions, pain management, and follow-up appointments to assess healing. Physical therapy may be recommended to aid in recovery and improve mobility. The duration of recovery can vary based on individual factors, including the extent of the surgery and the patient's overall health. It is essential for patients to adhere to their surgeon's post-operative guidelines to ensure optimal healing and successful outcomes.
| Short Descr | ARTHRD ANT DFRM 8+ VRT SGM | Medium Descr | ARTHRODESIS ANTERIOR SPINAL DFRM 8+ VRT SGM | Long Descr | Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments | 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 | 158 - Spinal fusion |
This is a primary code that can be used with these additional add-on codes.
| 20705 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) | 20930 | Addon Code MPFS Status: Bundled Code APC N ASC N1 CPT Assistant Article Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure) | 20931 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure) | 20936 | Addon Code MPFS Status: Bundled Code APC N ASC N1 CPT Assistant Article Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure) | 20937 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (List separately in addition to code for primary procedure) | 20938 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (List separately in addition to code for primary procedure) | 20939 | Addon Code MPFS Status: Active Code APC N ASC N1 Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2022-01-01 | Note | Short and Medium description changed. |
| 2018-01-01 | Note | Short Descriptor changed |
| 2013-01-01 | Note | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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