How To Use CPT Code 22864

CPT code 22864 describes the removal of a single artificial disc in the neck that was previously placed in a total disc arthroplasty procedure. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 22864?

CPT 22864 is used to describe the removal of a single artificial disc in the neck that was previously implanted in a total disc arthroplasty procedure. This code is specifically for the removal of one disc and should not be reported in conjunction with other codes such as 22861 or 69990. It is important to note that for additional interspace removal of cervical total disc arthroplasty, a different code, 0095T, should be used.

2. Official Description

The official description of CPT code 22864 is: ‘Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace cervical.’

3. Procedure

During the procedure, the provider begins by making a skin incision through the prior scar in the anterior neck. They then use sharp and blunt dissection to dissect through the scar tissue between the carotid sheath laterally and the esophagus and trachea medially. This allows them to expose the prevertebral space and identify the target segment. The screws holding the artificial disc in place are loosened, and the disc is removed. The provider then irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

CPT 22864 is performed on patients who have previously undergone a total disc arthroplasty procedure and require the removal of a single artificial disc in the neck. This procedure is typically performed to treat degenerative disc disease or other symptomatic disc conditions. It is important to note that this code should not be reported with other specific codes, such as 22861 or 69990.

5. When to use CPT code 22864

CPT code 22864 should be used when a provider is removing a single artificial disc in the neck that was previously implanted in a total disc arthroplasty procedure. This code is specific to the removal of one disc and should not be used for additional interspace removal. If additional interspace removal is required, a different code, 0095T, should be used.

6. Documentation requirements

To support a claim for CPT 22864, the provider must document the following information:

• Patient’s diagnosis and the need for disc removal
• Details of the procedure, including the approach used (anterior approach)
• Location of the incision and any scar tissue encountered
• Identification of the target segment and the specific disc being removed
• Confirmation of the loosening and removal of the screws holding the artificial disc in place
• Documentation of irrigation, hemostasis, removal of instruments, and closure of the incision

7. Billing guidelines

When billing for CPT 22864, it is important to ensure that the procedure meets the criteria for this specific code. The provider should use the appropriate code based on the number of discs being removed and should not report this code in conjunction with other specific codes, such as 22861 or 69990. It is also important to follow any additional billing guidelines provided by payers or regulatory bodies.

8. Historical information

CPT 22864 was added to the Current Procedural Terminology system on January 1, 2009. Since its addition, there have been several changes related to its status as an inpatient-only (IPO) procedure. In 2017, it was added to the IPO list, but in 2021, it was removed from the IPO list. However, in 2022, it was once again added to the IPO list.

9. Similar codes to CPT 22864

There are several similar codes to CPT 22864 that are used for different procedures or circumstances. These include:

• CPT 22861: This code is used for the removal of total disc arthroplasty (artificial disc), anterior approach, multiple interspaces cervical.
• CPT 69990: This code is used for the removal of neurostimulator electrodes, plate/paddle, or lead(s), including fluoroscopy, when performed.
• CPT 0095T: This code is used for the removal of total disc arthroplasty (artificial disc), anterior approach, single interspace cervical, with additional interspace removal(s).

9. Examples

1. A patient who previously underwent a total disc arthroplasty procedure requires the removal of a single artificial disc in the neck.
2. A provider performs the removal of a single artificial disc in the neck for a patient who experienced complications or discomfort related to the disc.
3. A patient’s condition changes, and the removal of a single artificial disc in the neck is necessary to address new symptoms or complications.
4. A provider identifies a problem with a single artificial disc in the neck during a routine follow-up visit and decides to remove it.
5. A patient requests the removal of a single artificial disc in the neck due to personal preference or dissatisfaction with the results of the total disc arthroplasty procedure.
6. A provider determines that the removal of a single artificial disc in the neck is necessary to address a specific complication or adverse reaction to the disc.
7. A patient experiences recurrent pain or discomfort in the area of the artificial disc, leading to the decision to remove it.
8. A provider discovers a problem with the single artificial disc in the neck during a diagnostic imaging study and decides to remove it.
9. A patient’s condition improves to the point where the artificial disc is no longer necessary, and the provider decides to remove it.
10. A provider performs the removal of a single artificial disc in the neck as part of a revision surgery to address complications or improve outcomes.