CPT CODES

CPT Code 22862

CPT code 22862 is for the revision or replacement of a total disc arthroplasty, including the lumbar region, involving one interspace.

Table of Contents
What is CPT Code 22862
Does CPT 22862 Need a Modifier?
CPT Code 22862 Medicare Reimbursement
Are You Being Underpaid for 22862 CPT Code?
Accelerate your revenue cycle

Boost patient experience and your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place.

Get a Demo

What is CPT Code 22862

CPT code 22862 is used to describe the procedure for the revision or replacement of a total disc arthroplasty (artificial disc) at a single interspace in the lumbar spine. This code is specifically utilized when a previously implanted artificial disc needs to be revised or replaced due to issues such as wear, malfunction, or other complications.

Does CPT 22862 Need a Modifier?

For CPT code 22862, which pertains to the revision of a replacement of a single interspace lumbar total disc arthroplasty, the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Use this modifier if the work required to perform the procedure is substantially greater than typically required. This could be due to factors such as increased complexity or time.

2. Modifier 50 - Bilateral Procedure: If the procedure is performed bilaterally, this modifier should be appended to indicate that the service was performed on both sides of the body.

3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier should be used to indicate that multiple distinct procedures were carried out.

4. Modifier 58 - Staged or Related Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if the procedure was planned or anticipated (staged) at the time of the original procedure.

5. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that the procedure is distinct or independent from other services performed on the same day.

6. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used if the procedure needs to be repeated by the same provider.

7. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used if the procedure needs to be repeated by a different provider.

8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.

9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if the procedure is unrelated to the original procedure and occurs during the postoperative period.

10. Modifier 80 - Assistant Surgeon: Use this modifier if an assistant surgeon is required for the procedure.

11. Modifier 81 - Minimum Assistant Surgeon: This modifier is used if an assistant surgeon is required for a minimal portion of the procedure.

12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.

13. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: This modifier is used when these non-physician practitioners assist in the surgery.

Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for the services provided.

CPT Code 22862 Medicare Reimbursement

CPT code 22862 is reimbursed by Medicare, but it is essential to verify the specific reimbursement details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment rates. Additionally, reimbursement can vary based on the region and the specific Medicare Administrative Contractor (MAC) overseeing claims in that area. Therefore, it is advisable to consult the MPFS and the relevant MAC for the most accurate and up-to-date information regarding the reimbursement of CPT code 22862.

Are You Being Underpaid for 22862 CPT Code?

Discover how MD Clarity's RevFind software can meticulously analyze your contracts and pinpoint underpayments down to the CPT code level, including specific codes like 22862. Ensure you're receiving the full reimbursement you deserve from every payer. Schedule a demo today to see RevFind in action.

Get paid in full by bringing clarity to your revenue cycle

Get a Demo

Related CPT Codes

Full Page Background