CPT Code 22856 | Description & Clinical Information

CPT 22856 describes the insertion of an artificial disc into a cervical interspace to address various conditions, including degenerative disc disease, disc disruption, internal disc derangement, and symptomatic disc desiccation, while also involving the removal of the intervertebral disc and bone spurs to alleviate pressure on the nerve root or spinal cord.

Official Description

The CPT book defines CPT code 22856 as: “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”.

Billing Guidelines

Do not bill CPT code 22856 together with CPT codes 22554, 22845, 22853, 22854, 22859, or 63075 if they are performed at the same level.

Do not bill for 22856 along with 69990 as per CPT guidelines.

To perform interspace cervical total disc arthroplasty, utilize CPT code 22858.

Clinical Information

The procedure described by CPT code 22856 is a complex surgical procedure that is primarily used to treat patients suffering from a herniated cervical disc. The cervical disc herniation, also known as a slipped disc or a ruptured disc, can cause severe pain, numbness, weakness, and tingling sensation in the arms, neck, and shoulders. Such pain and discomfort can significantly affect the patient’s quality of life and daily activities, and the CPT 22856 procedure aims to alleviate these symptoms by replacing the affected disc with an artificial one.

To perform the CPT 22856 procedure, the patient is first appropriately prepped and anesthetized. Once the patient is under anesthesia, the provider makes an incision through the skin of the anterior neck and carefully dissects through the tissue, taking care to protect the carotid vessels, esophagus, and trachea. This exposes the prevertebral space, where the damaged disc is located.

Using retractors, the provider then holds back the tissues to gain access to the damaged disc. The next step involves the removal of the affected cervical disc material with a surgical instrument. The provider uses an operating microscope and performs microdissection to clear the disc space thoroughly. All bone spurs and the bulging disc are removed to decompress the nerve root, which can relieve the patient’s symptoms.

Once the damaged disc has been removed, the provider guides a drill into the disc space to create a clear space for placing the artificial disc. The drill is also used to adjust the disc space to ensure proper alignment of the artificial disc. The provider carefully places the artificial disc into the cleared space without damaging any surrounding tissues.

In the final step, the provider stops all bleeding and carefully sutures the soft tissues in layers, closing the incision wound. The patient is then monitored in the recovery room for any complications that may arise.

The CPT 22856 procedure is a highly specialized and complex surgical procedure that requires significant skill and expertise. It is essential to choose a qualified and experienced surgeon to perform the procedure to ensure the best possible outcome for the patient. The recovery time following the surgery varies depending on the patient’s overall health, age, and lifestyle factors, such as smoking and exercise levels.

In conclusion, the CPT 22856 procedure is an effective treatment option for patients suffering from herniated cervical disc, and it can significantly improve their quality of life by relieving pain and discomfort. The procedure, although complex, has a high success rate when performed by a skilled and experienced surgeon. Patients undergoing the procedure should follow all pre- and post-operative instructions provided by their surgeon to ensure a smooth recovery process.

Return to all the CPT codes for spinal instrumentation procedures on the spine (vertebral column).

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