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CPT®
0163T

CPT® Code 0163T
Deleted

Code deleted. To report total disc arthroplasty [artificial disc], anterior approach, lumbar, see 22857, 22860.

Official Description

Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (List separately in addition to code for primary procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Total disc arthroplasty refers to a surgical procedure aimed at the complete replacement of a severely damaged or diseased intervertebral disc with an artificial disc. This procedure is particularly relevant for patients suffering from significant disc degeneration or other spinal disorders that compromise the integrity and function of the lumbar spine. The approach taken in this procedure is anterior, meaning that the surgeon accesses the lumbar vertebrae through an incision in the abdomen. This method allows for direct visualization and manipulation of the intervertebral space. The procedure involves not only the placement of the artificial disc but also a discectomy, which is the removal of the damaged disc material to prepare the interspace for the new implant. This code specifically applies to each additional interspace treated beyond the primary procedure, highlighting its use in cases where multiple discs require replacement. The artificial disc typically consists of two metal endplates and a polyethylene insert, designed to mimic the natural function of a healthy disc, allowing for movement and load-bearing capabilities in the spine. The overall goal of total disc arthroplasty is to restore spinal stability, alleviate pain, and improve the patient's quality of life by enabling better mobility and function.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure of total disc arthroplasty is indicated for patients experiencing significant spinal issues related to intervertebral disc degeneration or damage. The following conditions may warrant this surgical intervention:

  • Severe Disc Degeneration - When the intervertebral disc has deteriorated to the point where it causes chronic pain and limits mobility.
  • Herniated Discs - In cases where the disc material has protruded and is compressing nearby nerves, leading to pain, numbness, or weakness in the extremities.
  • Spinal Instability - When the structural integrity of the spine is compromised, resulting in abnormal movement between vertebrae.
  • Failed Conservative Treatments - Patients who have not responded to non-surgical treatments such as physical therapy, medications, or injections may be candidates for this procedure.

2. Procedure

The total disc arthroplasty procedure involves several critical steps to ensure successful implantation of the artificial disc. Each step is designed to prepare the intervertebral space and facilitate the proper placement of the implant.

  • Step 1: Anterior Access - The procedure begins with an anterior approach, where the surgeon makes an incision in the abdomen to access the lumbar spine. This approach allows for direct access to the intervertebral discs without disturbing the surrounding musculature significantly.
  • Step 2: Identification of the Target Disc - Once the abdominal incision is made, the surgeon retracts the intervertebral muscles and utilizes X-ray imaging to accurately identify the target disc that requires replacement. This step is crucial for ensuring that the correct interspace is treated.
  • Step 3: Discectomy - The next step involves performing a discectomy, where the damaged disc material is carefully removed using a rongeur. This process prepares the intervertebral space for the artificial implant by clearing out any pathogenic disc matter that could interfere with the placement of the new disc.
  • Step 4: Implant Preparation - After the discectomy, the surgeon prepares the interspace for the artificial disc. The artificial disc typically consists of two metal endplates and a polyethylene insert. The endplates are inserted into the prepared disc space in a collapsed state.
  • Step 5: Implant Placement - The metal endplates are seated into the vertebrae above and below the interspace. Once positioned, the endplates are opened with distraction, allowing for the placement of the polyethylene insert. This insert is designed to mimic the natural disc's function and is secured in place using a snap-lock mechanism.
  • Step 6: Closure - After the total disc replacement is successfully assembled, the surgeon closes the incision and may leave a drain in place to prevent fluid accumulation. This step concludes the surgical procedure.

3. Post-Procedure

Post-procedure care following total disc arthroplasty is essential for optimal recovery. Patients are typically monitored for any immediate complications related to the surgery. Pain management is a critical component of post-operative care, and patients may be prescribed medications to alleviate discomfort. Physical therapy is often recommended to aid in rehabilitation, focusing on strengthening the back and improving mobility. Patients are advised to follow specific activity restrictions to ensure proper healing and to avoid undue stress on the newly implanted disc. Regular follow-up appointments are necessary to assess the healing process and the functionality of the artificial disc. Overall, the expected recovery period may vary depending on individual circumstances, but adherence to post-operative guidelines is crucial for achieving the best possible outcomes.
Short Descr TOT DISC ARTHRP EA ADDL LMBR
Medium Descr TOT DISC ARTHRP ANT APPR EA ADDL NTRSPC LUMBAR
Long Descr Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (List separately in addition to code for primary procedure)
Status Code Carriers Price the Code
Global Days YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE Not applicable/unspecified.
CCS Clinical Classification 158 - Spinal fusion
Date
Action
Notes
2022-12-31 Deleted Code deleted. To report total disc arthroplasty [artificial disc], anterior approach, lumbar, see 22857, 22860.
2022-01-01 Changed Short and Medium description changed.
2009-01-01 Changed Code description changed
2007-01-01 Added First appearance in code book in 2007.
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