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The procedure described by CPT® Code 22868 involves the insertion of an interlaminar or interspinous process stabilization or distraction device in the lumbar region of the spine. This procedure is performed without fusion and includes image guidance when applicable. The primary goal of this intervention is to stabilize the lumbar spine and alleviate pressure on the spinal nerves, particularly in patients suffering from conditions such as spinal stenosis, which can lead to pain and neurogenic claudication. The interlaminar devices are strategically placed adjacent to the lamina and feature two sets of wings that encircle the inferior and superior spinous processes, thereby limiting excessive movement. Conversely, interspinous spacers are smaller devices that are inserted between the spinous processes and expanded to relieve nerve pressure. The procedure typically involves making a small incision over the targeted lumbar disc, followed by careful dissection through the subcutaneous tissue and deeper layers to access the spine. This meticulous approach allows for the effective decompression of the exiting and transversing nerve roots, ultimately aiming to improve the patient's quality of life by reducing pain and enhancing mobility.
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The procedure is indicated for patients experiencing symptoms related to spinal stenosis, which may include:
The procedure involves several critical steps to ensure successful insertion of the stabilization or distraction device:
Post-procedure care typically involves monitoring the patient for any complications and managing pain effectively. Patients may be advised on activity restrictions to promote healing and prevent strain on the surgical site. Follow-up appointments are essential to assess the success of the procedure and the patient's recovery progress. Rehabilitation may be recommended to strengthen the back and improve mobility.
| Short Descr | INSJ STABLJ DEV W/DCMPRN | Medium Descr | INSJ STABLJ DEV W/DCMPRN LUMBAR SECOND LEVEL | Long Descr | Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (List separately in addition to code for primary procedure) | Status Code | Active 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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 | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 22867 | MPFS Status: Active Code APC J1 ASC J8 Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level |
| 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code 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 | KX | Requirements specified in the medical policy have been met | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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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| 2017-01-01 | Added | Added |
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