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The procedure described by CPT® Code 22861 involves the revision and replacement of a total disc arthroplasty, specifically targeting the cervical spine through an anterior approach. This surgical intervention is typically performed when there are complications associated with a previously implanted artificial disc, which may include persistent pain, degenerative changes in the surrounding vertebrae, or misalignment of the spine at the treated or adjacent disc levels. The operation begins with an incision made in the front of the neck, positioned slightly off the midline to provide optimal access to the cervical spine. During the procedure, the esophagus is carefully retracted to prevent injury, and critical structures such as nerves and arteries are identified and safeguarded. The soft tissues of the neck are meticulously dissected to expose the spine, allowing for the retraction of intervertebral muscles to reveal the artificial disc. The existing disc is then removed, and the condition of the vertebral bodies is assessed for any bone loss or damage. If feasible, the disc space is prepared for the insertion of a new artificial disc, which involves milling and shaping the end plates to ensure a proper fit. The procedure emphasizes maintaining the natural curvature of the cervical spine while securing the new disc in place, followed by the closure of incisions and potential placement of a temporary drain to manage postoperative fluid accumulation.
© Copyright 2025 Coding Ahead. All rights reserved.
The revision of a cervical total disc arthroplasty is indicated under several circumstances, primarily when complications arise from the initial procedure. These indications include:
The procedure for revising a cervical total disc arthroplasty involves several critical steps, each designed to ensure the successful replacement of the artificial disc:
After the procedure, patients are typically monitored for any complications and may require postoperative care to manage pain and facilitate recovery. The expected recovery period can vary based on individual circumstances, but patients are generally advised to follow specific guidelines regarding activity restrictions and rehabilitation exercises to promote healing. The placement of a temporary drain may be utilized to prevent fluid buildup, and follow-up appointments are essential to assess the success of the revision and the function of the new artificial disc.
| Short Descr | REV RPLCM ARTHRP 1NTRSPC CRV | Medium Descr | REVJ W/RPLCMT TOT DISC ARTHRP ANT 1 NTRSPC CRV | Long Descr | Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical | 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 3 - Laminectomy, excision intervertebral disc |
This is a primary code that can be used with these additional add-on codes.
| 0098T | Addon Code MPFS Status: Carrier Priced APC C CPT Assistant Article Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (List separately in addition to code for primary procedure) |
| 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery |
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| 2023-01-01 | Note | Short and medium descriptions changed. |
| 2017-01-01 | Note | AMA Guidelines changed. |
| 2009-01-01 | Added | - |
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