The Rapid Response Committee continues to work aggressively to protect patient access to appropriate spine care. Two issues been recent focuses of the committee in an effort to maintain proper access and proper payer interpretation of coding.

Revision Cervical Arthroplasty

Cervical arthroplasty has been FDA approved for almost a decade. However, for the first several years, cervical arthroplasty was coded with a category III code. As a reminder, Category III codes are tempo- rary codes for to allow for data collection and track utilization of new and emerging technology, whereas Category I codes are used for procedures which are consistent with standard medical practice, and are widely performed. While a device may be FDA approved, it may have a category III code. In most cases, this becomes an impetus for

payers to consider the device“experimental and not medically necessary.” The category III code for cervical arthroplasty limited widespread utilization of the procedure for many years until enough data was published in the literature, and a category I code was obtained. Since then, cervical arthroplasty has become more widespread, and is now part of the medial policy for most payers.

While cervical arthroplasty, which has been studied extensively since its IDE studies in the mid-2000’s, has achieved acceptance by payers and a category I CPT code, the code for revision of cervical arthroplasty has remained a category III code (0095T). Considering that the proto- typical patient undergoing cervical arthroplasty is young, with one or two soft disc herniations, and minimal degenerative or spondylytic disease, it is not unexpected that the number of revisions of cervical arthroplasty devices would be small. However, as with any treatment, there will be failures, although rare. Since initial cervical arthroplasty is considered a standard and accepted procedure, the revision should also achieve a category I code for those indicated cases.