Skip to Main Content

Effective September 1, 2021: Benefit Changes to Total Disc Arthroplasty for Medicaid and CHIP

Date: 07/27/21

Effective September 1, 2021, Total Disc Arthroplasty will become a benefit for Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and CHIP members 13 years of age and older, and will require Prior Authorization (PA). TurningPoint Healthcare Solutions, LLC will process PA requests for medical necessity for the services listed below. Physicians will be able to submit requests to TurningPoint for PA beginning August 23, 2021 for dates of service on or after September 1, 2021.

Current Procedural Terminology (CPT) Codes

Description

22856

Total disc arthroplasty (artificial disc), anterior approach

22858

Total disc arthroplasty (artificial disc), anterior approach, second level

22861

Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace

22864

Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace


For questions regarding this notification, utilization management or PA, and to submit PA requests, please contact TurningPoint at: