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Thread: 22305 vertebral process fracture

  1. #1

    Default 22305 vertebral process fracture

    AAPC: Back to School
    Can anyone explain what CPT 22305 is? What is the Orthopaedist doing when performing this code? Can this code be used for a compression fracture care code when no brace, no splint, no cast, and no manipulation was performed?

  2. #2
    Join Date
    Apr 2007
    North Carolina


    22305=Closed treatment of a vertebral process fracture is only indicated if the spine is stable and the type of fracture does not require intervention. In the case of the cervical spine, the physician initially immobilizes the patient's neck and spine with sandbags or a cervical collar, as necessary.

    This procedure could be performed for a compression fx (733.13)

  3. #3


    This is my scenario : The physician is wanting to bill CPT 99213-57, 22310 both with the diagnosis code 805.3.
    Note states:

    Patient here for follow up. Overall back is better, however patient still has pain. Patient did have an MRI of T-Spine which is positve for what appears to be a vertberal body end plate fracture of T8-T10 which maybe due to subacute compression deformities but also appears to be a mild compression deformity of T7-T10 from prior fractures.
    At this point physician would like patient to see a spinal specialist. Physician gave name of a spinal specialist and recommended a bone density as well. Patient is also going to start physiotherapy and work on the flexibilty of the patient's spine.

    I do not agree how the physician wants to bill this service. Could this be for a CPT 22305 with diagnosis 733.13? Any suggestions are greatly appreciated.

  4. #4
    Join Date
    Apr 2007
    North Carolina


    I don't see anything about an injury. The documentation leads me to believe this could be a non-traumatic compression fracture. Especially since there is mention of a bone density study. Ideally, it would also be nice to see something about the cervical collar or some type of treatment of the fracture. If this is all that's documented, a carrier could dispute 22305. If it were me, I would query the provider about the diagnosis and the documentation for 22305.

  5. #5


    The 1st visit which was a consult stated that patient was riding a horse and felt a "pop" and a crack in the spine. The patient was in a lot of pain. The physician should of documented this information in the next note which is above correct? Is CPT 22305 only used for a traumatic injury? or for a non-traumatic injury?

  6. #6
    Join Date
    Apr 2007
    North Carolina


    22305 can be used for both; non-traumatic and traumatic. Although each note should stand on its own, there does seem to be a "trial" explaining the circumstances.

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