Orthopedic Coding Alert

Question: Our surgeon performed a disk replacement using a Charite artificial disk. I am planning to report 0091T for the arthroplasty itself, along with 22851 for the disk. Is this accurate?

Washington, D.C., Subscriber Answer: When placing an artificial lumbar disk, you should rely on 0091T (Total disk arthroplasty [artificial disk], anterior approach, including diskectomy to prepare interspace [other than for decompression]; single interspace, lumbar) as your only code to describe the service.
 
You should not report 22851 (Application of intervertebral biomechanical device[s] [e.g., synthetic cage(s), threaded bone dowel(s), methylmethacrylate] to vertebral defect or interspace) in addition to 0091T because the -T- code includes the surgeon's work removing the old disk, placing the disk prosthesis.
 
Exception: You may report 22851 during the same session as 0091T only if the surgeon places an intervertebral biomechanical device at a different level.
 
In other words, you can use 22851 to describe instrumentation placed elsewhere on the spine during artificial disk procedures.