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The procedure described by CPT® Code 22862 involves the revision and replacement of a total disc arthroplasty, specifically through an anterior approach at a single interspace in the lumbar region of the spine. This surgical intervention is typically necessitated by various factors, including persistent pain, degenerative changes in the spine, or misalignment of the spine at the previously treated or adjacent disc spaces. During the procedure, the surgeon makes an incision in the abdomen to access the lumbar spine. The intervertebral muscles are carefully retracted to expose the existing artificial disc. The surgeon then dissects the artificial disc from the end plates of the vertebrae and removes it, while assessing any bone loss or damage to the vertebral bodies. If the conditions allow for a new disc to be placed, the disc space is meticulously prepared by milling and shaping the end plates above and below the interspace to accommodate the new artificial disc. Tension is applied to the vertebral bodies to facilitate the opening of the disc space, allowing for the insertion of the new artificial disc. The new disc, which consists of two metal plates surrounding a polyurethane core and saline cushion, is then positioned into the prepared space, ensuring that the normal curvature of the spine is maintained. In cases where replacement is necessary, the failed implant is removed, and the interspace is explored and prepared for the insertion of a new prosthesis or component. Finally, the fascia and muscle tissue are repaired, and the surgical wound is closed, often with a drain left in place to prevent fluid accumulation.
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The procedure described by CPT® Code 22862 is indicated for patients experiencing specific conditions related to the lumbar spine. These indications include:
The procedure for CPT® Code 22862 involves several critical steps to ensure the successful revision and replacement of the total disc arthroplasty. These steps include:
Post-procedure care following the revision and replacement of a total disc arthroplasty includes monitoring the patient for any signs of complications, managing pain, and ensuring proper healing of the surgical site. Patients may be advised on activity restrictions and rehabilitation protocols to support recovery. Follow-up appointments are essential to assess the success of the procedure and the functionality of the new artificial disc. Additionally, any concerns regarding the surgical site or changes in symptoms should be promptly addressed by the healthcare provider.
| Short Descr | REV RPLCM RTHRP 1NTRSPC LMBR | Medium Descr | REVJ W/RPLCMT TOT DISC ARTHRP ANT 1 NTRSPC LMBR | Long Descr | Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar | Status Code | Restricted Coverage | 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) | 2 - Team surgeons permitted; pay by report. | 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 | 158 - Spinal fusion |
This is a primary code that can be used with these additional add-on codes.
| 0165T | 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, lumbar (List separately in addition to code for primary procedure) |
| 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. |
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| 2023-01-01 | Note | Short and medium descriptions changed. |
| 2009-01-01 | Changed | Code description changed |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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