This page addresses follow-up questions and additional information pertinent to our webinar
Next Level Spine Coding Part 1: Walking Through Case Studies for Posterior Spinal Fusions.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.

Q: What is the difference between vertebral segment and interspace?
A: A vertebral segment and an interspace are related anatomical terms within the context of the spine, but they refer to slightly different concepts:

1. Vertebral Segment: This refers to a functional unit of the spine. It consists of two adjacent vertebrae along with the intervertebral disc, ligaments, and associated muscles. The vertebral segment is the basic unit of movement and support in the spine.
2. Interspace: This refers to the space between two adjacent vertebrae. It’s typically where the intervertebral disc is located, along with other structures such as ligaments and nerves. The term “interspace” is often used when discussing procedures such as spinal injections or surgeries, where precise identification and targeting of specific levels are crucial.

So, in essence, while a vertebral segment encompasses the entire functional unit involving two vertebrae and associated structures, an interspace specifically denotes the gap or space between two individual vertebrae.

Q: What code is used if they are crossing from cervical to thoracic or thoracic to lumbar?
A: When a posterior spinal fusion procedure crosses from one anatomical region to another, such as from cervical to thoracic or from thoracic to lumbar, the appropriate CPT code to use would depend on the specific details of the procedure performed and the number of vertebral segments fused. Here are some possible scenarios and corresponding CPT codes:

1. Posterior spinal fusion involving cervical and thoracic levels:
   1. If the fusion involves multiple vertebral segments crossing from the cervical spine to the thoracic spine, you may use:
      1. CPT code 22600: Arthrodesis, posterior or posterolateral technique, single level; cervical (with or without lateral mass fixation)
      2. Plus, an additional code for each additional level fused, such as:
      3. CPT code 22614: each additional vertebral segment (List separately in addition to code for primary procedure)
2.  Posterior spinal fusion involving thoracic and lumbar levels:
   1. If the fusion involves multiple vertebral segments crossing from the thoracic spine to the lumbar spine, you may use:
      1. CPT code 22610: Arthrodesis, posterior or posterolateral technique, single level; thoracic
      2. Plus, an additional code for each additional level fused, such as:
      3. CPT code 22614: each additional vertebral segment (List separately in addition to code for primary procedure)

Q: Can we code Smith Peterson osteotomy separately with spinal deformity fusion?
A: Yes, as long as the documentation supports both services.

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