2025 CPT code 22861
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spinal Instrumentation Procedures on the Spine (Vertebral Column) Surgical Procedures on the Musculoskeletal System Feed
Revision, including replacement, of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical.
Modifier 51 (multiple procedures) may apply if additional procedures are performed during the same surgical session. Modifier 62 (two surgeons) may apply if two surgeons work together, each performing distinct portions of the procedure.Modifiers should only be applied according to official guidelines.
Medical necessity for this procedure is established through objective findings demonstrating failed or infected total disc arthroplasty.This typically includes persistent pain, radiological evidence of implant failure (e.g., subsidence, loosening), infection, or instability at the surgical site, despite conservative management.Medical necessity documentation must support the need for revision, compared to alternative treatment options.
The clinical responsibility involves a thorough understanding of cervical spine anatomy and the surgical technique for anterior cervical spine surgery, including the management of associated vascular and airway structures. The surgeon must be proficient in performing anterior approaches to the cervical spine, removing existing implants, inserting new implants, and managing potential complications. Postoperative care, including pain management and follow-up, is also part of the clinical responsibility.
- Surgical Procedures on the Musculoskeletal System
- Spinal Instrumentation Procedures on the Spine (Vertebral Column)
In simple words: The doctor replaces a previously implanted artificial disc in the neck.This is done through an incision in the front of the neck, and involves removing the old disc and putting in a new one.Special care is taken to avoid damaging nearby blood vessels and airways.
This CPT code encompasses the revision and replacement of a previously implanted total disc arthroplasty in a single cervical interspace, accessed via an anterior approach.The procedure involves removal of the existing artificial disc and its components, followed by insertion of a new artificial disc.The approach is from the front of the neck, requiring careful dissection to avoid damage to surrounding structures like the carotid sheath, esophagus, and trachea.Fluoroscopic guidance is often used for precise placement of the new implant.The procedure includes the necessary steps for preparation, exposure, implant removal and replacement, wound closure, and post-operative care, as defined by the CPT guidelines. This code should not be used in conjunction with certain other codes at the same spinal level as defined in the CPT guidelines.
Example 1: A 55-year-old patient with a history of a previous anterior cervical discectomy and fusion (ACDF) presents with persistent neck pain and radiological evidence of implant failure. The surgeon performs a revision of the ACDF, replacing the failed implant with a new cervical disc prosthesis., A 60-year-old patient who underwent a total disc arthroplasty (TDA) three years prior experiences recurrent neck pain and infection at the implant site.The surgeon performs a revision procedure, removing the infected implant and replacing it with a new sterile implant., A 48-year-old patient develops instability at the site of a prior cervical TDA.The surgeon performs a revision procedure, correcting the instability and replacing the original implant with a different type of implant to improve stability.
Preoperative imaging (X-rays, CT, MRI) showing the need for revision surgery. Operative report detailing the procedure, including the type of implant used and complications encountered. Postoperative imaging showing the successful placement of the new implant.Complete medical history and physical examination notes addressing the reasons for revision.Documentation of informed consent for the procedure.
** Always refer to the most current CPT coding guidelines for complete and accurate coding and billing practices.The information provided here is for educational purposes and should not be used as a sole source for billing decisions. Consult the official CPT manual and payer-specific guidelines.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: This information requires access to a specific payer's fee schedule and may vary widely. RVUs are not directly provided in the source data.
- Global Days: The global period for this procedure is not explicitly defined in the provided text and varies by payer and other factors.Further clarification is needed through a payer's specific fee schedule.
- Payment Status: Active
- Modifier TC rule: The application of a technical component (TC) modifier is not directly applicable to this code; however, it may depend on specific payer policies and the circumstances of the procedure. This should be verified with the relevant payer.
- Fee Schedule: Historical fee schedules are not available in this dataset. To access historical fee schedule information, consult fee schedule databases from relevant payers.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center