0098T CPT Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

CPT 0098T: Revision and Replacement of Cervical Artificial Disc, Add-On

CPT code 0098T designates an add-on surgical procedure for revision and replacement of an artificial cervical disc in a different cervical interspace performed during the same operative session as an initial cervical artificial disc repair. This code is used when the implanted arthroplasty device has shifted, been damaged, or otherwise requires intraoperative correction, and it captures the additional resource use and surgical complexity of addressing a second cervical level during the same encounter. Nationally, accurate use of this code matters for correct procedural reporting, clinical documentation, and appropriate payment for multilevel cervical arthroplasty revisions.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a focused overview of clinical context and operative setting for 0098T, common billing considerations, and what to expect in payer coverage patterns and coding practice. The publication also outlines benchmarks and policy updates relevant to reporting add-on cervical arthroplasty revision procedures and highlights documentation elements that typically support use of the code. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0098TCPTcervical artificial discspine surgeryrevision surgeryadd-on procedureoperative sessionorthopedic surgeryneurosurgery

Billing Code Overview

CPT code 0098T is an add-on procedure for revision and replacement of an existing artificial cervical disc in a different cervical interspace performed during the same operative session as an initial cervical artificial disc repair. The procedure addresses situations in which an arthroplasty device has migrated, become malpositioned, or is otherwise damaged and requires revision and replacement.

Service type: Revision and replacement of an existing cervical artificial disc as an add-on procedure during the same operative session as the initial cervical artificial disc repair
Typical site of service: Hospital inpatient or hospital outpatient surgical setting; may also occur in an ambulatory surgery center depending on case complexity and payer rules

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with a prior cervical total disc arthroplasty at the C4–C5 level presents months after the index procedure with new onset neck pain, radiculopathy, and imaging demonstrating migration and component failure of the artificial disc at the adjacent C5–C6 level. The surgical team plans an operative session to revise the damaged/loosened device and replace a second artificial disc at a different cervical interspace during the same anesthesia event. Preoperative workflow includes history and physical, review of prior operative reports and implant records, cervical CT and MRI to assess device position and bone quality, implant explantation planning, and informed consent for revision arthroplasty. Intraoperative workflow includes general endotracheal anesthesia, intraoperative neuromonitoring as indicated, exposure of the cervical spine via anterior approach, careful removal of the failed device, preparation of the adjacent interspace, placement of the replacement cervical artificial disc, verification of alignment under fluoroscopy, hemostasis, and layered closure. Postoperative workflow includes recovery in PACU, postoperative imaging to confirm positioning, pain management, physical therapy instructions, and documentation of the add-on revision procedure performed in the same operative session as the initial cervical artificial disc repair. The billed procedure is the add-on service described by 0098T for revising and replacing another cervical artificial disc at a separate cervical interspace during the same operative session.

Coding Specifications

Modifier	Description	When to Use

CPT 0101T: Shock Wave Therapy for Musculoskeletal Pain

CPT-0109T-HEAT-PAIN-SENSORY-THRESHOLD-TESTING-EXTREMITY

CPT 0109T: Heat Pain Sensory Threshold Testing, Extremity

CPT-0232T-IMAGE-GUIDED-PRP-PREPARATION-AND-INJECTION

CPT 0232T: Image-Guided Platelet-Rich Plasma Preparation and Injection

CPT-0211T-AUDITORY-WORD-RECOGNITION-TEST

CPT 0211T: Auditory Word Recognition Test

CPT-0184T-TRANSANAL-ENDOSCOPIC-MICROSURGICAL-EXCISION-RECTAL-TUMOR

CPT 0184T: Transanal Endoscopic Microsurgical Excision of Rectal Tumor

CPT-0207T-THERMAL-PRESSURE-TREATMENT-MEIBOMIAN-GLAND-DYSFUNCTION-DRY-EYE

CPT 0207T: Thermal and Pressure Treatment for Meibomian Gland Dysfunction

CPT-0221T-LUMBAR-FACET-JOINT-SPACER-IMPLANTATION-IMAGE-GUIDED

CPT 0221T: Lumbar Facet Joint Spacer Implantation, Image-Guided

CPT-0107T-VIBRATION-SENSATION-THRESHOLD-ASSESSMENT

CPT 0107T: Vibration Sensation Threshold Assessment

CPT-0209T-AIR-AND-BONE-CONDUCTION-HEARING-THRESHOLD-TESTING

CPT 0209T: Air and Bone Conduction Hearing Threshold Testing

CPT-0075T-EXTRACRANIAL-VERTEBRAL-ARTERY-STENT-PLACEMENT

CPT 0075T: Extracranial Vertebral Artery Stent Placement

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Taxonomy Code	Specialty	Notes
207XS0101X	Orthopaedic Surgery	Common specialty performing cervical spine arthroplasty and revision procedures.
2086S0102X	Neurological Surgery	Neurosurgeons frequently perform cervical disc arthroplasty and complex revisions.
207L00000X	Spine Surgery (Orthopedics)	Focused spine surgeons or fellowship-trained orthopaedic spine specialists perform these procedures.
207QA0000X	Pain Medicine (Anesthesiology)	May be involved preoperatively for pain optimization and postoperative pain management.
207T00000X	Orthopaedic Surgery of the Spine	Subspecialty taxonomy for surgeons performing cervical disc replacement and revisions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M50.20`	Other cervical disc displacement, unspecified cervical region	Cervical disc displacement may be the underlying degenerative process leading to prior arthroplasty and subsequent device failure or need for revision.
`M50.30`	Other cervical disc degeneration, unspecified cervical region	Degenerative disc disease can necessitate arthroplasty and may contribute to adjacent-level device issues requiring revision.
`M50.11`	Cervical disc disorder with radiculopathy, high cervical region	Radiculopathy is a common clinical presentation prompting both primary disc replacement and revision when device migration causes nerve root compromise.
`T85.898A`	Other complications of internal prosthetic device, implant and graft, initial encounter	Used to report device complication such as migration, loosening, or mechanical failure of the artificial disc prompting revision.
`M99.03`	Subluxation complex (vertebrae), cervical region	Instability or subluxation detected on imaging may be an indication for revision and replacement of the cervical device.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0098T`	Revision and replacement of another artificial disc in another cervical interspace at the same operative session as an initial cervical artificial disc repair (add-on)	This is the specific add-on code describing the revision/replacement of a second cervical artificial disc performed during the same operative session.
`22856`	Total disc arthroplasty (artificial disc), anterior approach, cervical, single interspace, including discectomy to prepare interspace (includes arthroplasty device)	Common primary procedure for cervical artificial disc implantation; may be performed as the initial or concurrent device placement with which `0098T` is associated.
`22858`	Total disc arthroplasty (artificial disc), anterior approach, cervical, two interspaces, including discectomy to prepare interspaces (includes arthroplasty device for both interspaces)	Used when two-level cervical disc arthroplasty is performed as primary procedure; `0098T` applies when revising/replacing an additional disc during the same session rather than primary two-level billing.
`22842`	Posterior instrumentation (e.g., lateral mass, transpedicular) with fixation	May be performed if revision requires supplemental posterior fixation due to instability after device removal.
`20930`	Allograft, morselized, or placement of bone graft extenders/biologics	May be used adjunctively if bone grafting or biologic augmentation is necessary during revision.
`76000`	Fluoroscopy (radiologic guidance) for localization and device positioning	Intraoperative imaging commonly used to verify implant position during explantation and replacement.

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