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Official Description

Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment

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Common Language Description

Vertebral corpectomy is a surgical procedure that involves the resection of the vertebral body, which is the main part of a vertebra, along with the intervertebral discs located above and below the affected vertebra. This procedure is typically indicated for patients suffering from severe spinal stenosis, which is a narrowing of the spinal canal that can lead to compression of the spinal cord or nerve roots. Conditions such as bone spurs, fractures, tumors, or infections affecting the spine may also necessitate this intervention. The procedure is performed using a combined thoracolumbar approach, which allows access to the lower thoracic and lumbar regions of the spine. A co-surgeon team, often consisting of a thoracic surgeon and a spine surgeon, collaborates to ensure optimal exposure and execution of the procedure. The thoracic incision is strategically extended to provide adequate access to the affected spinal segments, facilitating the removal of the vertebral body and associated structures. This comprehensive approach aims to alleviate pressure on the spinal cord and nerve roots, thereby improving patient outcomes and restoring spinal stability.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Vertebral corpectomy is performed for several specific indications, including:

  • Severe Spinal Stenosis - A condition characterized by the narrowing of the spinal canal, which can lead to compression of the spinal cord or nerve roots.
  • Bone Spurs - Bony projections that develop along the edges of bones, which can cause pain and restrict movement by impinging on nerve structures.
  • Fractures - Breaks in the vertebrae that may compromise spinal stability and lead to neurological deficits.
  • Tumors - Abnormal growths within or around the vertebrae that can exert pressure on the spinal cord or nerve roots.
  • Infections - Pathological conditions affecting the spine, such as osteomyelitis, that may necessitate the removal of infected vertebral tissue.

2. Procedure

The vertebral corpectomy procedure involves several critical steps, which are detailed as follows:

  • Step 1: Incision and Exposure - The procedure begins with an incision made over the thorax to access the thoracic spine. The incision may be extended over the abdomen to ensure adequate exposure of the lower thoracic and lumbar segments. Overlying muscles are dissected, and one or more ribs may be resected to facilitate access.
  • Step 2: Dissection of Intervertebral Discs - Once the spine is adequately exposed, the intervertebral discs located above and below the targeted vertebral body are carefully dissected from surrounding tissues and removed using a surgical microscope. This step is crucial for alleviating pressure on the spinal cord and nerve roots.
  • Step 3: Removal of Bone Spurs and Ligaments - Any bone spurs or bony structures that are impinging on the nerve roots are excised. Additionally, the ligament covering the spinal cord is removed to further relieve compression.
  • Step 4: Excising the Vertebral Body - The affected vertebral body is then excised, completing the resection of the compromised structures.
  • Step 5: Bone Grafting and Fusion - Following the corpectomy, separately reportable bone grafting and fusion procedures are performed. A bone graft is placed in the surgical defect to support the anterior aspect of the spine, ensuring stability and promoting fusion with adjacent bone.
  • Step 6: Stabilization - Internal fixation may be utilized to stabilize the spine, providing additional support during the healing process.
  • Step 7: Closure - Upon completion of the procedure, bleeding is controlled, a chest tube is placed if necessary, and the thorax and abdomen are closed in layers to promote proper healing.

3. Post-Procedure

After the vertebral corpectomy, patients typically require careful monitoring and post-operative care. Expected recovery may involve pain management, physical therapy, and gradual mobilization to restore function. The placement of a chest tube may necessitate additional care to monitor for any complications related to lung function. Follow-up appointments are essential to assess the healing process and ensure that the bone graft is integrating properly with the surrounding bone. Patients may also need to adhere to specific activity restrictions to promote optimal recovery and prevent complications.

Short Descr REMOV VERTBR DCMPRN THRCLMBR
Medium Descr VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG
Long Descr Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment
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) 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met.
Team Surgery (66) 2 - Team surgeons permitted; pay by report.
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) P1F - Major procedure - explor/decompr/excis disc
MUE 1
CCS Clinical Classification 3 - Laminectomy, excision intervertebral disc

This is a primary code that can be used with these additional add-on codes.

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)
63088 Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (List separately in addition to code for primary procedure)
69990 Addon Code MPFS Status: Restricted APC N ASC N1 PUB 100 CPT Assistant Article 1Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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.
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.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
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
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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2013-01-01 Changed Short Descriptor changed.
Pre-1990 Added Code added.
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