WEST CHESTER, PA — Centinel Spine®, LLC announced that effective January 1, 2023, providers may begin utilizing a new Current Procedural Terminology (CPT®) code when performing two-level lumbar total disc arthroplasty via an anterior approach. To increase the availability of two-level lumbar total disc replacement (TDR) to individuals experiencing degeneration of the intervertebral discs, the American Medical Association (AMA) accepted the addition of a new Category I CPT code for a second level of lumbar TDR in late 2021. Centinel Spine’s prodisc® L is the only total disc replacement system in the U.S. approved for two-level use in the lumbar spine.
New CPT codes are created after review by the AMA CPT Editorial Panel and minimally meet several criteria, including:
- The device is FDA-approved.
- The procedure is performed by many physicians across the United States.
- The procedure is performed with frequency consistent with the intended clinical use (i.e., a service for a common condition should have high volume).
- The procedure is consistent with current medical practice.
- The clinical efficacy of the procedure is documented in literature that meets the requirements set forth in the CPT code-change application.
The Editorial Panel consists of a cross-functional membership of medical specialty societies; the Blue Cross and Blue Shield Association; and others that represent America’s Health Insurance Plans (AHIP) and private health organizations. The CPT codes created and maintained by the AMA CPT Editorial Panel are widely used by third party payors, including Medicare, Medicaid, and commercial health plans.
“This new CPT code will allow more patients access to two-level lumbar total disc replacement,” commented Dr. Vivek Mohan, MD from the Orthopaedic Spine Institute, Schaumburg, IL. “There is a significant number of patients with symptomatic two-level Degenerative Disc Disease in the lumbar spine, and this will impact their ability to benefit from the advantages of lumbar disc replacements.”
Centinel Spine CEO Steve Murray further notes, “Through the efforts of physician partners and medical societies, this new CPT code expands access to life changing technologies for patients by opening new reimbursement pathways. The prodisc L device is the only disc that has FDA approval for two-level indications and has been a benefit for patients with lumbar disc disease of this severity. Having two-level approval has helped Centinel pursue its mission to provide clinically-proven products that allow individuals to continue to function at a high level.”
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