The procedure for a total disc arthroplasty generally takes 2-3 hours and will necessitate two surgeons. The anterior approach for this procedure will require a surgeon (often a vascular surgeon) to create the anterior access by making an incision and moving organs and blood vessels out of harm’s way. Then, the orthopedic surgeon or neurosurgeon will perform the discectomy and implant the artificial disc. Once the arthroplasty is complete, the first surgeon will return to facilitate the closure.
Source: https://altairhealth.com/artificial-disc-replacement/
For 2023, the CPT code description for a total lumbar disc
arthroplasty underwent a change. As a
matter of fact, it was very minor change, but with a major impact. A semicolon was added to the code description
which now reads as follows:
22857 Total disc
arthroplasty (artificial disc), anterior approach, including
discectomy to prepare
interspace (other than for decompression);
single
interspace, lumbar
The point of the semicolon addition was to allow for the inclusion of a new code to capture disc arthroplasty performed on a second interspace. This means that code 22857 is now a parent code for the add-on code of 22860. This new code, +22860, captures the total disc arthroplasty on a second lumbar interspace.
+22860 second interspace, lumbar
Source: https://www.centinelspine.com/camp_totalsolution.php?utm_source=OTW&utm_medium=socialmedia_ad&utm_campaign=TotalSolution_TotalConfidence_11-21
Coding professionals should be aware that if more than two lumbar interspaces are involved in the procedure, unlisted procedure code 22899 for an unlisted procedure of the spine should be coded.
It is also worth noting that the discectomy itself is considered part of codes 22857 and 22860.
There are two more CPT codes related to total lumbar disc arthroplasty procedures. 22862 is for a revision which includes replacement of total lumbar disc arthroplasty. If additional levels are revised, then category III CPT code +0164T would be assigned for each additional lumbar interspace. 22865 will be assigned to capture the removal of an artificial lumbar disc, with category III CPT code +0165T assigned for each additional lumbar interspace where a removal of the artificial disc takes place.
Now, light has been shed on total lumbar arthroplasty coding.
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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.
