CPT code

[JasonNYC]

anybody know the CPT code for charite disc replacement in the united states. I need to get it so I cna give it to my insurance company to see ifthey will cover my surgery

[Juli]

That link didn't work for me previously. or it is highly possible I just didn't underestand what I was reading. I called my insurance company and they didn't have 0091T in their database. ESL gave me what was on his pre-auth form, he had 63090 63091 and 22851 but I havent called back yet to check if they had those instead.

[Juli]

Cat, I was thinking of asking if anyone was using tricare and how they were reacting. I am retired military but have not signed up for tricare, I just use my insurance through work as it is not too expensive. I take it they are reacting the same as most others then?

[ESL]

there was one person on this board working thru tricare (kinda unsuccessfully so far)....search for "military" and i am sure those threads pop up.

[ans]

His name is Leland Hendrix. I tried an unsuccesful search. He may be on other boards and was finally succesful after numerous appeals w/Tricare.

[Cat-mt]

Are you saying that Tricare approved his ADR? If they did then it is very important that I talk to him, do you know how to get a hold of him. I have to turn in my appeal by 1 May, if I can find out for sure that they approved for him than they will have to approve for me also. You could give him my email addy and let him contact me. mikencat1122@yahoo.com If this is true than there is a light at the end of the big black hole. Thanks Cathy

[Cat-mt]

Sorry one more thing. Do you know if he is active duty or dependent or retired?

[ans]

Cathy: sent email. Best, ans

[Cat-mt]

I found a listing of CPT Codes for ADR they are so follows:

0090T Total disc arthroplasty (artificial disc), anterior approach, including diskectomy to prepare interspace (other than for decompression) single interspace; cervical.

0091T Total disc arthroplasty (artificial disc), anterior approach, including diskectomy to prepare interspace (other than for decompression) single interspace; lumbar

0092T each additional interspace
(List separately in addition to code for primary procedure)

0093T Removal of total disc arthroplasty, anterior approach, single interspace; cervical

0094T Removal of total disc arthroplasty, anterior approach, single interspace; lumbar

0095T each additional interspace
(List separately in addition to code for primary procedure)

0096T Revision of total disc arthroplasty, anterior approach single interspace; cervical

(Do not report 0096T with 0093T)

0097T Revision of total disc arthroplasty anterior approach single interspace; lumbar

(Do not report 0097T with 0094T)

0098T each additional interspace (List separately in addition to code for primary procedure)

(Do not report 0098T with 0095T)

(Do not report 0090T-0098T in conjunction with 22851, 49010, when performed at the same level)

(Includes fluoroscopy when performed)(For decompression, see 63001-63048)

I hope this will help.
Cathy

[Leland Hendrix]

Sorry guys. My battle was lost.

I was trying to get to Wilford Hall Medical Center, and had gotten an appointment to see a Dr. Maj Steven Cyr there. He is an advocate of ADR, and performed one there in March.

Before I could get to TX, my clinic processed an MEB and recommended discharge and 20 % disability. I'm floored, and of course am fighting it as best I can. But I don't have much hope. Even my MEB contained inaccurate information.

I'll likely get spit out into the VA system, which is already overloaded and unlikely to be of long-term help to get my life back.

If I can be of any further help, please feel free to contact me.

Leland