How To Use CPT Code 22865

CPT code 22865 describes the removal of a single artificial disc in the lower back 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 22865?

CPT 22865 is used to describe the removal of a single artificial disc in the lower back that was previously placed in a total disc arthroplasty procedure. This code is specifically for the anterior approach and involves the removal of the disc in a single interspace in the lumbar spine.

2. Official Description

The official description of CPT code 22865 is: ‘Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace lumbar.’

3. Procedure

During the procedure, the provider reopens the incision on the left side of the abdomen and exposes the muscles of the anterior abdominal wall. They identify and mobilize the rectus muscle and take down any adhesions from the previous surgical procedure. Care is taken not to violate the peritoneum. The provider then identifies and protects the left ureter and mobilizes major arteries and veins as needed for exposure. Rongeurs and curettes are used to carefully remove the previously placed artificial disc. The area is irrigated, checked for bleeding, and any instruments are removed. Finally, the incision is closed in layers.

4. Qualifying circumstances

CPT 22865 is used when a patient has previously undergone a total disc arthroplasty procedure and now requires the removal of a single artificial disc. This procedure is typically performed to treat degenerative disc disease or other symptomatic disc conditions. The anterior approach is used, and the removal is done in a single interspace in the lumbar spine.

5. When to use CPT code 22865

CPT code 22865 should be used when a provider is performing the removal of a single artificial disc in the lower back using the anterior approach. This code is specifically for the removal of a disc in a single interspace in the lumbar spine. It should not be used for other types of disc removal procedures or for removals in different areas of the spine.

6. Documentation requirements

To support a claim for CPT 22865, the provider must document the following information:

• Patient’s diagnosis and the need for disc removal
• Specific details of the procedure, including the approach used and the interspace in which the disc was removed
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 22865, ensure that the procedure meets the criteria for this specific code. It should be an anterior approach removal of a single artificial disc in the lumbar spine. It is important to review any additional guidelines or requirements from the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 22865 was added to the Current Procedural Terminology system on January 1, 2007. There have been several historical changes to the code, including updates to the description and its inclusion or exclusion from the Inpatient Only (IPO) list for Medicare patients.

9. Similar codes to CPT 22865

There are several similar codes to CPT 22865 that may be used for different procedures or approaches. These include:

• CPT 22840: Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace cervical
• CPT 22842: Removal of total disc arthroplasty (artificial disc), anterior approach, second level, cervical
• CPT 22845: Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace thoracic
• CPT 22850: Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace cervical
• CPT 22852: Removal of total disc arthroplasty (artificial disc), anterior approach, second level, cervical

9. Examples

1. A patient who previously underwent a total disc arthroplasty in the lumbar spine requires the removal of a single artificial disc using the anterior approach.
2. A provider performs the removal of a single artificial disc in the lumbar spine using the anterior approach for a patient with degenerative disc disease.
3. A patient with a symptomatic disc condition undergoes the removal of a single artificial disc in the lumbar spine using the anterior approach.
4. A provider performs the removal of a single artificial disc in the lumbar spine using the anterior approach for a patient who experienced complications from the previous disc arthroplasty.
5. A patient requires the removal of a single artificial disc in the lumbar spine due to a failed total disc arthroplasty procedure.
6. A provider performs the removal of a single artificial disc in the lumbar spine using the anterior approach for a patient with recurrent symptoms after a previous disc arthroplasty.
7. A patient who previously underwent a total disc arthroplasty in the lumbar spine requires the removal of a single artificial disc due to an infection.
8. A provider performs the removal of a single artificial disc in the lumbar spine using the anterior approach for a patient with adjacent segment disease.
9. A patient with a symptomatic disc condition undergoes the removal of a single artificial disc in the lumbar spine using the anterior approach to address ongoing pain and dysfunction.
10. A provider performs the removal of a single artificial disc in the lumbar spine using the anterior approach for a patient who experienced a fracture of the artificial disc.