CPT® Code 0098T

Add-On Code

1. Indications

The procedure associated with CPT® Code 0098T is indicated for patients experiencing complications related to previously implanted cervical total disc arthroplasties. These complications may include:

• Persistent Pain: Ongoing discomfort that may not have improved following the initial disc arthroplasty.
• Degenerative Changes: Deterioration of the disc or surrounding structures that may necessitate revision.
• Improper Alignment: Misalignment of the spine at the treated or adjacent disc spaces that could lead to further complications.

2. Procedure

The procedure for CPT® Code 0098T involves several critical steps to ensure the successful revision of the cervical total disc arthroplasty:

• Step 1: Anterior Approach Incision An incision is made in the front of the neck, just off the midline of the spine. This approach allows the surgeon to access the cervical spine directly.
• Step 2: Retraction of Soft Tissues The esophagus is carefully retracted to provide a clear view of the surgical site. During this step, the surgeon also identifies and protects the surrounding nerves and arteries to prevent any injury.
• Step 3: Exposure of the Existing Artificial Disc The soft tissues of the neck are dissected, and the intervertebral muscles are retracted to expose the previously placed artificial disc. This step is crucial for evaluating the condition of the existing device.
• Step 4: Evaluation of the Vertebral Bodies The surgeon assesses the amount of bone loss and any damage to the vertebral bodies surrounding the artificial disc. This evaluation helps determine whether a new disc can be placed.
• Step 5: Preparation for New Artificial Disc If a new disc is to be inserted, the intervertebral space is prepared by milling and shaping the end plates above and below the space to accommodate the new artificial disc.
• Step 6: Insertion of the New Artificial Disc Tension is applied to the vertebral bodies above and below the disc space to open it, allowing for the placement of the new artificial disc. The new disc is then inserted, ensuring that the two metal plates surrounding the polyurethane core and saline cushion are pressed into the prepared bony end plates.
• Step 7: Restoration of Cervical Lordotic Curvature Care is taken to maintain the normal cervical lordotic curvature during the insertion. Once the new artificial disc is in place, tension is released from the vertebral bodies, which compresses the disc and holds it securely in position.

3. Post-Procedure

After the procedure, patients are typically monitored for any immediate complications. Post-operative care may include pain management, physical therapy, and follow-up appointments to assess the success of the revision. The expected recovery time can vary based on individual patient factors and the extent of the surgery performed. It is essential for patients to adhere to their physician's post-operative instructions to ensure optimal healing and recovery.