Wiki 3-Level Cervical Artificial Disc Replacement

[tpardo]

Hello Everyone,

I need some assistance on coding for a 3-level cervical artificial disc replacement, I am getting two variations of the coding and need to find which is the accurate coding for the case.

Scenario 1 - 22899
Scenario 2 - 22856 / 22858 / 22899

Which of these two scenarios would you state is the correct manner in which to code the case?

Any help that can be provided would be greatly appreciated.

Thanks so much,
Tresha

 

[amyjph]

Which did you choose and why would you code it that way? Are you asking because you have multiple coders doing it a different way and you are trying to "tie-break"?
Also, it is difficult to assist when only a small piece of the case is listed. Was there anything else done at the same time?

 

[Mluong]

Hello tpardo,

Implants for cervical disk replacement is approved up to 2 levels by FDA. Therefore, many insurance payers will cover up to 2 level disk replacement. Accordting to CPT book, lumbar disk replacement for level 3 is reported as 22899 (unlisted procedure, spine). I think it is very likely that insurance payer would not cover for this procedure. There is no CPT code for cervical disk replacement for level 3, so it would be appropriate to report 3 level cervical disk replacement with 22856, 22858 and 22899. This way, you can receive payment for level 1 and 2. Unlisted procedure code 22899 might be challenging to get payment.
However, I‘m very skeptical if a surgeon performed a 3 level cervical disk replacement. Due to the cervical anatomy (smaller structure comparing to lumbar), if more than 2 cervical levels have problem, surgeon is more likely to opt for cervical fusion. I would query the provider if actual 3-level cervical disk replacement was done.