CPT code 22533 is a medical billing code for arthrodesis, a surgical procedure to fuse vertebrae in the lumbar spine.
CPT code 22533 is for an arthrodesis procedure, which involves the surgical fusion of a joint in the lumbar (lower back) region of the spine. This specific code indicates that the procedure is performed using a lateral extracavitary approach, meaning the surgeon accesses the spine from the side of the body without entering the chest or abdominal cavities.
For CPT code 22533 (Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar), the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly greater effort than typically required. Documentation must support the substantial additional work.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed bilaterally, this modifier should be appended to indicate that the service was performed on both sides of the body.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier should be used to indicate that multiple services were provided.
4. Modifier 52 - Reduced Services: If the procedure was partially reduced or eliminated at the physician's discretion, this modifier should be used to indicate that the service provided was less than usually required.
5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It is often used to identify procedures that are not typically reported together but are appropriate under the circumstances.
6. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure, this modifier should be used to indicate that each surgeon performed a distinct part of the procedure.
7. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same physician needs to repeat the procedure on the same day.
8. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when a procedure is repeated by a different physician on the same day.
9. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used if the patient requires a return to the operating room for a related procedure during the postoperative period.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: If an unrelated procedure is performed by the same physician during the postoperative period, this modifier should be used.
11. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required to assist with the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: Use this modifier when a minimum assistant surgeon is required for the procedure.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is required because a qualified resident surgeon is not available.
14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: This modifier is used when a non-physician provider assists in the surgery.
Each of these modifiers serves a specific purpose and should be used in accordance with the clinical scenario and documentation to ensure accurate coding and reimbursement.
CPT code 22533, which refers to "Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar," is reimbursed by Medicare. The reimbursement amount can vary based on several factors, including geographic location and the specific Medicare Administrative Contractor (MAC) policies. As of the latest available data, the national average reimbursement for CPT code 22533 is approximately $1,500. However, it is crucial to verify the exact reimbursement rate with your local MAC or through the Medicare Physician Fee Schedule (MPFS) for the most accurate and up-to-date information.
Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 22533 for arthrodesis of the lumbar spine. Ensure you're receiving the full reimbursement you deserve from every payer. Schedule a demo today to see RevFind in action and protect your revenue.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
