These total disc replacement procedures are performed at either the cervical or lumbar regions of the spine. Codes for both levels include the removal of the disc and are for a single interspace only. Add-on codes are available if an additional procedure is performed at a second level during the same encounter.
Disc replacements may be performed to treat conditions such as degenerative disc disease, herniated discs, or spondylotic myelopathy. The goal of disc replacement is to alleviate nerve compression, preserve spinal motion, and reduce pain.
22856 Total
disc arthroplasty (artificial disc), anterior approach, including discectomy with
end plate
preparation (includes osteophytectomy for nerve root or spinal cord
decompression)
and microdissection); single interspace, cervical
+22858 second level, cervical
22857 Total
disc arthroplasty (artificial disc), anterior approach, including discectomy to
prepare
interspace (other than for decompression); single interspace, lumbar
+22860 second interspace, lumbar
As identified by a blue triangle at CPT code 22857, there was a minor change in 2023 which was to add the semi-colon in the description. This allows the addition of a new add-on code for capturing of the total disc arthroplasty done on a second interspace. If more than two lumbar interspaces are involved in the procedure, use the unlisted procedure of the spine code 22899.
Now, light has been shed on coding for total disc
replacements.
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About the Author
Dianna Foley, RHIA, CCS, CHPS, CDIP, is
OHIMA's Education Coordinator. Dianna has been an HIM
professional for over 20 years. She progressed through the ranks of coder,
department supervisor, and department director, to her current role as a
coding consultant. She previously served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati and holds RHIA, CHPS, CDIP and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and is a presenter on coding topics at the national, state, and regional levels. Dianna mentors new AHIMA members and also provides monthly educational lectures to coders and clinical documentation specialists.
