Artificial Cervical Disc Placement

Question:

We are just starting to do these procedures and I want to get our coding sorted out. We will be doing a cervical discectomy with decompression under fluoroscopy and implanting the artificial disc. We think the correct codes are: 22551(anterior cervical discectomy and decompression), 22856 (total disc arthroplasty) and 76000 (fluoroscopy). Are we right?

Answer:

How exciting to add a new procedure to the practice! And, kudos for being proactive about the coding. Actually, CPT 22856 includes the discectomy, decompression and placement of the implant. Additionally, it would not be accurate to separately report 22551 because an arthrodesis (also included in 22551) is not performed in this procedure. Lastly, fluoroscopy (76000) is included in all open spine surgical procedure codes and not separately reported. Therefore, 22856 covers the entire procedure for a one-level total disc arthroplasty. CPT +22858 would be used for the second level if performed.

22856 Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical

*This response is based on the best information available as of 10/03/19.