Discuss AAPC CPC Exam Topic 7 Question 51

A 60-year-old male suffering from degenerative disc disease at the L3-L4 and L5-S1 levels was placed under general anesthesi

a. Using an anterior approach, the L3-L4 disc space was exposed. Using blunt dissection, the disc space was cleaned. The disc space was then sized and trialed. Excellent placement and insertion of the artificial disc at L3-L4 was noted. The area was inspected and there was no compression of any nerve roots. Same procedure was performed on L5-S1 level. Peritoneum was then allowed to return to normal anatomic position and entire area was copiously irrigated. The wound was closed in a layered fashion. The patient tolerated the discectomy and arthroplasty well and was returned to recovery in good condition. What CPT coding is reported for this procedure?

A22857 x 2

B22857, 22860

C22857

D22899

Suggested Answer: A

This scenario describes an anterior discectomy and arthroplasty at two levels (L3-L4 and L5-S1) using artificial discs. CPT code 22857 describes total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar. Since the procedure was performed at two levels, the code should be reported twice.

AMA's CPT Professional Edition (current year), Code 22857

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23 comments · newest first

Aliza 10 months ago

22857 x 2 is standard for this type of procedure.

Ashton 10 months ago

I agree, B makes the most sense here.

Larae 10 months ago

Wow, I didn't realize they could do both levels at once like that!

Georgeanna 10 months ago

Wait, are we sure about that? I thought it might be just A.

Ashton 11 months ago

Definitely think it's B, 22857 and 22860 for the two levels.

Erick 11 months ago

I believe the correct answer is B, since both levels were treated, but I could be mixing it up with another case we reviewed.

Dion 11 months ago

I vaguely recall that 22857 is for the artificial disc itself, but I can't remember if we need to add another code for the second level.

Fairy 11 months ago

I think we practiced a similar question where we had to identify the correct CPT codes for a discectomy and arthroplasty. I feel like 22857 is definitely involved, but I'm not sure about the second code.

Rikki 12 months ago

I remember we discussed the codes for spinal procedures, but I'm a bit unsure about how to differentiate between the artificial disc codes.

Clement 12 months ago

This is a tricky one. There are a few different options, and I'm not entirely sure which one is the most appropriate. I'll need to double-check the coding guidelines to make the best choice.

Glennis 12 months ago

Okay, let me think this through step-by-step. The key details I need to focus on are the anterior approach, the discectomy and arthroplasty at two levels. I'm pretty confident I can figure out the right coding for this.

Louann 1 year ago

I'm a bit confused about the different codes here. I'll need to review the details of each one to make sure I choose the right one.

Lili 1 year ago

Hmm, this seems like a pretty straightforward question. I think I've got a good handle on the CPT coding for this type of procedure.

Ira 1 year ago

Ah, I see what you mean, Ming. The key is that the same procedure was done at two different levels, so it's likely 22857, 22860 would be the right answer.

Mel 1 year ago

↳ replying to Ira

Right, so it's probably 22857, 22860.

Louann 1 year ago

↳ replying to Ira

Good point, but if both levels are involved, it still makes sense.

Carin 1 year ago

↳ replying to Ira

I agree with you, Ming. Both levels were treated.

Ming 1 year ago

Wait, doesn't the question mention that the same procedure was performed on both the L3-L4 and L5-S1 levels? If that's the case, then the correct code should be 22857, 22860.

Hollis 1 year ago

↳ replying to Ming

I think you're right, the correct code should be 22857, 22860.

Lenny 1 year ago

I disagree, I believe the correct answer is B) 22857, 22860.

Cammy 1 year ago

I think the answer is A) 22857 x 2.

Lindsey 1 year ago

Hmm, this seems straightforward. The procedure involves two artificial disc replacements, so I'm guessing the correct code is 22857 x 2.

Marylyn 1 year ago

↳ replying to Lindsey

I think you're right, it should be 22857 x 2 for the two artificial disc replacements.

AAPC CPC Exam - Topic 7 Question 51 Discussion