New CPT Code for 2-Level Cervical Disc Replacement

The American Medical Association (AMA) CPT Editorial Panel has added a new Category I CPT code for two-level cervical total disc arthroplasty. The code will go into effect January 1, 2015.

The Current Procedural Terminology (CPT) code set is a medical code set maintained by the AMA. The code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes.

CPT coding is similar to ICD-9 and ICD-10 coding, except that it identifies the services rendered rather than the diagnosis on the claim.

Category I CPT codes are assigned to procedures that are deemed to be within the scope of medical practice across the U.S. In general, such codes report services whose effectiveness is well supported in the medical literature and whose constituent parts have received clearance from the FDA.

The AMA Relative Value System Update Committee (RUC) will now develop value recommendations for the code. Once the RUC has approved the value recommendations, they will be forwarded to the Centers for Medicare and Medicaid Services (CMS) for consideration in the 2015 Medicare physician fee schedule.

William Watters III, M.D., the president of the North American Spine Society, wrote his members on March 3, 2014 to say that after a review of the proposal from NASS regarding a new code, the AMA CPT Editorial Panel added the code and revised the existing Category III CPT code to describe disc arthroplasty performed at three or more levels.

“These changes will allow for accurate reporting of additional levels and will preserve the ability to obtain a Category I code for three or more level arthroplasty in the future as more literature becomes available, ” Watters stated in the letter.