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Total disc arthroplasty is a surgical procedure aimed at the complete replacement of a severely damaged or diseased intervertebral disc with an artificial disc. This procedure is specifically indicated for the lumbar region of the spine and is performed through an anterior approach, which involves making an incision in the abdomen to access the lumbar vertebrae. The process begins with the careful retraction of the intervertebral muscles to expose the target disc, which is then confirmed using radiological guidance. The damaged disc material is meticulously removed using a rongeur, preparing the interspace for the insertion of the artificial implant. The artificial disc typically consists of two metal endplates and a polyethylene insert that bears weight. The endplates are inserted into the prepared disc space in a collapsed state and are then expanded to fit securely into the vertebrae above and below. The polyethylene insert is subsequently placed and secured within the endplates using a snap-lock mechanism. After the successful assembly of the artificial disc, the surgical wounds are closed, and a drain may be left in place to prevent fluid accumulation. This procedure is reported using CPT® code 22857 for a single lumbar interspace, while code 22860 is used for a second lumbar interspace if applicable.
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The total disc arthroplasty procedure is indicated for patients experiencing severe degeneration or damage to the intervertebral disc in the lumbar region, which may result in significant pain, reduced mobility, or other debilitating symptoms. The following conditions may warrant this surgical intervention:
The total disc arthroplasty procedure involves several critical steps to ensure successful implantation of the artificial disc. The following outlines the procedural steps:
Post-procedure care following total disc arthroplasty is essential for optimal recovery. Patients are typically monitored for any complications and may be advised on pain management strategies. Physical therapy may be recommended to aid in rehabilitation and to restore mobility. The expected recovery period can vary, but patients are generally encouraged to gradually resume normal activities while avoiding high-impact movements. Follow-up appointments are crucial to assess the success of the procedure and to ensure proper healing of the surgical site.
| Short Descr | TOT DISC ARTHRP 1NTRSPC LMBR | Medium Descr | TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR | Long Descr | Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); single interspace, lumbar | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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 | 1 | CCS Clinical Classification | 158 - Spinal fusion |
This is a primary code that can be used with these additional add-on codes.
| 22860 | Add-on Code MPFS Status: Active Code APC C Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GA | Waiver of liability statement issued as required by payer policy, individual case | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit |
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Date
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Action
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Notes
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| 2023-01-01 | Changed | Code description changed. |
| 2022-01-01 | Note | 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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