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Anterior thoracic vertebral body tethering (AVT), also referred to as vertebral body tethering (VBT), is a surgical procedure designed to address severe and progressive scoliosis of the thoracic spine. This technique serves as an alternative to traditional spinal fusion, allowing for the correction of spinal deformities while preserving the natural growth and mobility of the spine. The procedure is specifically indicated for children and adolescents who possess sufficient growth potential, making it a suitable option for those whose skeletal development is not yet complete. During the procedure, a flexible cord, known as a tether, is strategically placed to facilitate gradual correction of the spinal curvature. The surgical approach involves making three small incisions, each approximately 2.5 cm in length, located in a line beneath the armpit. Through these incisions, endoscopic instruments are introduced to perform the necessary surgical tasks. The procedure includes the placement of anchors and bone screws on the outer side of the spinal curvature, to which the tether cord is secured using additional set screws. By applying tension to the tether cord, the surgeon can partially straighten the spine, and as the patient continues to grow, the tether cord will further guide the vertebrae into a straighter alignment. The duration of the procedure varies, with tether placement for a single curve typically taking between 2 to 3 hours, while procedures addressing double curves may extend to 4 to 6 hours. For coding purposes, CPT® Code 22836 is used for tether placement involving up to 7 vertebral segments, whereas CPT® Code 22837 is designated for procedures involving 8 or more vertebral segments.
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The procedure of anterior thoracic vertebral body tethering (AVT) is indicated for specific conditions related to spinal deformities. The following are the explicitly provided indications for this procedure:
The anterior thoracic vertebral body tethering procedure involves several critical steps to ensure effective correction of scoliosis. The following procedural steps are outlined:
Post-procedure care for patients undergoing anterior thoracic vertebral body tethering includes monitoring for any complications and ensuring proper recovery. Patients can expect a recovery period during which they may experience some discomfort, which can be managed with appropriate pain relief measures. Follow-up appointments are essential to assess the progress of spinal correction and to monitor the patient's growth and development. The surgeon will provide specific instructions regarding activity restrictions and rehabilitation exercises to support recovery and optimize outcomes.
| Short Descr | ANT THRC VRT BODY TETHRG 8+ | Medium Descr | ANT THORACIC VRT BODY TETHERING 8+ VRT SEGMENTS | Long Descr | Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 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) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 1 - Team surgeons could be paid, though... | 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) | none | MUE | 1 |
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| 2024-01-01 | Added | Code Added. |
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