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Vertebral corpectomy is a surgical procedure that involves the removal of a vertebral body along with the intervertebral discs situated above and below the affected vertebra. This operation is specifically indicated for the excision of intraspinal lesions or tumors that are located within the spinal canal and are either within or extending into the dura mater, which is the protective covering of the spinal cord. The procedure is performed on a single segment of the thoracic spine, which is the middle section of the vertebral column. Access to the thoracic spine is achieved through a thoracolumbar approach, which necessitates a thoracotomy, a surgical incision into the chest wall. This approach allows for adequate exposure of the thoracic spine, enabling the surgeon to effectively remove the lesion or tumor. Typically, this procedure is carried out by a surgical team, often involving a thoracic surgeon who performs the exposure and a spine surgeon who conducts the corpectomy. The operation requires careful dissection of the overlying muscles and may involve resection of one or more ribs to facilitate access to the thoracic spine. The use of a surgical microscope is common during the procedure to enhance visibility and precision when excising the lesion or tumor and repairing the dura mater post-excision.
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Vertebral corpectomy is indicated for the following conditions:
The procedure of vertebral corpectomy involves several critical steps to ensure successful excision of the lesion and proper reconstruction of the spine.
Post-procedure care for patients undergoing vertebral corpectomy typically involves monitoring for any complications related to the surgery, such as infection or cerebrospinal fluid leaks. Patients may require pain management and physical therapy to aid in recovery. The expected recovery period can vary based on individual patient factors and the extent of the surgery performed. Follow-up appointments are essential to assess the healing process and the effectiveness of the bone graft and any instrumentation used. Rehabilitation may focus on restoring mobility and strength in the thoracic region while ensuring that the spine remains stable during the healing process.
| Short Descr | REMOV VERT IDRL BDY THRCLMBR | Medium Descr | VERTEBRL CORPECT LES 1 SEG IDRL THRC THORACOLMBR | Long Descr | Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach | 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
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) | 63308 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segment) | 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) |
| 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). |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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