Summary & Overview
CPT 0095T: Additional Cervical Artificial Disc Removal (Add-On)
CPT code 0095T designates an add-on procedure for removal of an additional cervical artificial disc performed in the same operative session as an initial cervical artificial disc removal. This code captures incremental work and resources when more than one cervical interspace requires removal of an artificial disc during a single surgery. Nationally, accurate reporting of add-on surgical codes like 0095T is important for procedure-level resource accounting, claims accuracy, and consistent clinical documentation.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for cervical artificial disc removal, the service setting implications for hospital inpatient versus outpatient surgical workflows, and guidance on common billing elements associated with add-on surgical codes. The publication also summarizes expected benchmarks where available and notes policy considerations relevant to coverage and claim processing for add-on spine procedures.
The analysis covers clinical description, typical sites of service, payer coverage landscape, common modifiers and billing considerations, and areas where input data was not provided. Data not available in the input will be identified explicitly in the relevant sections.
Billing Code Overview
CPT code 0095T is an add-on surgical procedure code used when a provider removes an additional cervical artificial disc at the same operative session as an initial cervical artificial disc removal. The procedure represents an additional-level disc removal performed in the cervical spine during the same surgery as the primary artificial disc removal.
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Service type: Surgical/add-on procedure for cervical artificial disc removal
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Typical site of service: Hospital inpatient or outpatient surgical setting (operating room) depending on clinical indications and payer site definitions
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient with a history of prior cervical total disc replacement presents with progressive neck pain, radiculopathy, and radiographic evidence of prosthesis failure and device loosening at two contiguous cervical levels. After multidisciplinary evaluation including neurosurgery or orthopedic spine surgery, the operative plan is removal of the failed cervical artificial disc at one interspace with simultaneous removal of a second artificial disc at an adjacent cervical interspace during the same anesthetic session. The procedure is performed in an operating room, typically at a hospital inpatient or ambulatory surgery center, under general endotracheal anesthesia. Preoperative workflow includes imaging review (plain radiographs and CT/MRI as indicated), informed consent discussing risks of explantation and possible fusion, anesthesia evaluation, and documentation of prior implant details. Intraoperative steps include exposure of the cervical interspaces, careful explantation of the initial prosthesis, removal of the additional prosthesis at the second interspace (reported as add‑on procedure 0095T), hemostasis, and either revision reconstruction (such as fusion or replacement) or staged closure depending on intraoperative findings. Postoperative workflow includes recovery in PACU, neurologic monitoring, pain control, discharge planning (same‑day discharge or inpatient admission based on clinical status), and detailed operative and implant removal reports for coding and billing reconciliation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |