CPT® Code 22858

Add-On Code

Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (List separately in addition to code for primary procedure)

Total disc arthroplasty (CPT® Code 22858) refers to a surgical procedure that involves the replacement of a damaged or diseased cervical disc with an artificial disc. This procedure is performed through an anterior approach, meaning the incision is made at the front of the neck. The surgery includes a discectomy, which is the removal of the affected disc, along with end plate preparation to ensure proper placement of the artificial disc. Additionally, the procedure may involve osteophytectomy, which is the removal of bone spurs that could be compressing nearby nerves or the spinal cord, and microdissection to carefully separate and protect the surrounding nerves and blood vessels during the operation. The artificial cervical disc is designed to mimic the natural function of a healthy disc, allowing for motion at the disc space, which is a significant advantage over traditional spinal fusion techniques that restrict movement. The procedure is particularly beneficial for patients with severe disc degeneration or damage, as it aims to alleviate pain and restore function while preserving spinal mobility. The surgical technique requires careful dissection of the soft tissues in the neck, retraction of the esophagus, and meticulous exposure of the spine to access the intervertebral space. After the damaged disc is removed, the end plates of the adjacent vertebrae are prepared to receive the artificial disc, ensuring a secure fit and optimal function. This procedure is typically performed at a second cervical level when indicated, and the appropriate coding must reflect this additional level of treatment.