CPT® Code 22860

Add-On Code

Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (List separately in addition to code for primary procedure)

Total disc arthroplasty is a surgical procedure aimed at the complete replacement of a severely damaged or diseased intervertebral disc with an artificial disc. This procedure is performed through an anterior approach, which involves making an incision in the abdomen to access the lumbar vertebrae. The primary goal of this surgery is to alleviate pain and restore function by replacing the affected disc with a prosthetic device. During the procedure, the surgeon retracts the intervertebral muscles to gain access to the disc space, and radiological guidance is utilized to accurately identify the target disc. The damaged disc material is then removed using a rongeur, which prepares the interspace for the insertion of the artificial implant. Various designs of artificial discs exist, but a common type features two metal endplates that house a convex, weight-bearing polyethylene insert. The endplates are inserted into the prepared disc space in a collapsed state and are seated into the adjacent vertebrae. Once positioned, the endplates are distracted to open them, allowing the polyethylene insert to be placed securely within the endplates using a snap-lock mechanism. After the total disc replacement is completed, the surgical wounds are closed, and a drain may be left in place to prevent fluid accumulation. This code, CPT® 22860, is specifically used to report the total disc arthroplasty performed at the second lumbar interspace, in addition to the primary procedure code.