CPT® Code 0164T

Add-On Code

1. Indications

The procedure described by CPT® Code 0164T is indicated for the removal of a previously placed artificial total disc arthroplasty in the lumbar region. This may be necessary due to various reasons, including:

• Device Failure The artificial disc may have malfunctioned or failed, necessitating its removal.
• Infection The presence of an infection around the implant may require surgical intervention to remove the device.
• Persistent Pain Patients may experience ongoing pain or discomfort that is attributed to the artificial disc, leading to the decision for removal.
• Complications Complications such as migration of the implant or adjacent segment disease may warrant the removal of the artificial disc.

2. Procedure

The procedure for the removal of total disc arthroplasty via CPT® Code 0164T involves several critical steps, which are detailed as follows:

• Step 1: Incision The procedure begins with the surgeon making an incision in the abdominal area to access the lumbar spine. This incision is strategically placed to minimize damage to surrounding tissues and facilitate a clear view of the surgical site.
• Step 2: Retraction of Tissues Once the incision is made, the surgeon carefully retracts the abdominal muscles and surrounding tissues to expose the spinal column. This step is crucial for providing adequate access to the intervertebral spaces where the artificial disc is located.
• Step 3: Identification of the Implant The surgeon locates the artificial disc implant within the intervertebral space. This may involve navigating through any adhesions or fibrous tissue that have formed around the implant since its initial placement.
• Step 4: Distraction and Unseating To facilitate the removal of the implant, distraction is applied to open the intervertebral space. This allows the surgeon to unseat the artificial disc from its position between the vertebrae above and below, making it easier to extract the device.
• Step 5: Exploration and Debridement After the implant is removed, the surgical site is thoroughly explored. Any debris or damaged tissue is debrided to ensure a clean environment for healing and to prevent future complications.
• Step 6: Closure Finally, the surgeon closes the muscle and tissue layers in their original position. This step is essential for proper wound repair and to promote healing in the affected area.

3. Post-Procedure

Post-procedure care following the removal of total disc arthroplasty involves monitoring the patient for any signs of complications, such as infection or excessive bleeding. Patients may be advised to follow specific guidelines for activity restrictions to allow for proper healing. Pain management strategies will be implemented to address any discomfort following the surgery. Follow-up appointments will be scheduled to assess the recovery process and ensure that the surgical site is healing appropriately. Rehabilitation may be recommended to restore mobility and strength in the lumbar region, depending on the individual patient's needs and recovery progress.