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The procedure described by CPT® Code 22864 involves the surgical removal of a total disc arthroplasty, commonly referred to as an artificial disc, specifically in the cervical region of the spine. This procedure is performed through an anterior approach, which means that the surgeon accesses the cervical spine from the front of the neck. The operation begins with an incision made just off the midline of the neck, allowing the surgeon to gain access to the cervical interspace where the artificial disc is located. During the procedure, careful attention is given to retract the esophagus to prevent injury and to identify and protect surrounding nerves and arteries. The soft tissues of the neck are meticulously dissected to expose the spine, and the intervertebral muscles are retracted to reveal the artificial disc. The surgeon then dissects the artificial disc from the end plates of the vertebrae and removes it. An important aspect of this procedure is the evaluation of any bone loss or damage to the vertebral bodies that may have occurred. After the artificial disc is successfully removed, the surgeon may perform additional procedures to stabilize the cervical spine, which are separately reportable. In some cases, a temporary drain may be placed to manage any potential fluid accumulation post-surgery.
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The procedure is indicated for patients who have undergone total disc arthroplasty in the cervical spine and require removal of the artificial disc due to various reasons. These may include:
The procedure for the removal of a total disc arthroplasty involves several critical steps, each performed with precision to ensure patient safety and optimal outcomes.
Post-procedure care involves monitoring the patient for any signs of complications, such as infection or excessive bleeding. Patients are typically advised on activity restrictions to promote healing and prevent strain on the surgical site. Follow-up appointments are essential to assess recovery and to determine if any additional interventions are necessary. The placement of a temporary drain, if utilized, will be monitored and managed according to standard postoperative protocols. Patients may also receive instructions regarding pain management and rehabilitation to support their recovery process.
| Short Descr | RMVL TOT ARTHRP 1NTRSPC CRV | Medium Descr | RMVL TOT DISC ARTHRP ANT 1 INTERSPACE CERVICAL | Long Descr | Removal 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.
| 0095T | Addon Code MPFS Status: Carrier Priced APC C CPT Assistant Article Removal of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (List separately in addition to code for primary procedure) | 20704 | Add-on Code MPFS Status: Active Code APC N Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) | 20705 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2023-01-01 | Note | Short and medium descriptions changed. |
| 2009-01-01 | Added | - |
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