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2025 CPT code 22856

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

Follow CPT guidelines for spinal instrumentation and arthroplasty.Consult payer-specific guidelines for coverage requirements and preauthorization.

Modifiers 51 (multiple procedures) and 62 (two surgeons) may be applicable depending on the circumstances.

Medical necessity is established by documenting the presence of significant neck pain and neurological symptoms (radiculopathy) caused by degenerative disc disease or trauma, refractory to conservative management.The procedure must be deemed appropriate for the patient's condition and age. Imaging must support the diagnosis.

The surgeon performs an anterior neck incision, dissects through tissue to expose the prevertebral space, removes the damaged disc and bone spurs using microsurgical techniques, prepares the disc space, and implants the artificial disc.Hemostasis and wound closure are included.

IMPORTANT:Do not report 22856 in conjunction with 22554, 22845, 22853, 22854, 22859, 63075, when performed at the same level. Do not report 22856 in conjunction with 69990. For additional interspace cervical total disc arthroplasty, use 22858.

In simple words: The doctor replaces a damaged disc in your neck with an artificial one. They remove the old disc and any bone spurs causing pressure on nerves, improving neck pain and function.

This procedure involves the anterior approach replacement of a single cervical intervertebral disc with an artificial disc.It includes discectomy, endplate preparation, osteophytectomy for nerve root or spinal cord decompression, and microdissection.The procedure is performed to treat conditions such as degenerative disc disease, disc disruption, internal disc derangement, and symptomatic disc desiccation.

Example 1: A 50-year-old patient presents with chronic neck pain and radiculopathy due to degenerative disc disease at C5-C6.Total disc arthroplasty (22856) is performed to replace the damaged disc., A 45-year-old patient experiences severe neck pain following a motor vehicle accident with disc disruption at C4-C5.Total disc arthroplasty (22856) is performed to alleviate pain and restore spinal stability., A 60-year-old patient has symptomatic disc desiccation at C6-C7 causing significant neck pain and limited range of motion.Total disc arthroplasty (22856) is performed, addressing the desiccated disc and associated osteophytes.

Preoperative imaging (X-rays, MRI, CT scans) demonstrating degenerative disc disease or other indications. Operative report detailing the procedure performed, including disc removal, bone spur removal, and artificial disc implantation.Postoperative imaging confirming correct placement of the artificial disc.Patient history and physical examination findings demonstrating symptoms consistent with the diagnosis.

** Code 22858 should be reported separately in addition to 22856 when a second cervical interspace is treated during the same procedure.

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