Fusion of spine, lumbar region. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code. ICD-10-CM Diagnosis Code Z47.89 [convert to ICD-9-CM] Encounter for other orthopedic aftercare. Orthopedic aftercare; Orthopedic aftercare done; Removal of cast; Removal of cast done. ICD-10-CM Diagnosis Code Z47.89.
Fusion of thoracolumbar spine; Thoracolumbar ankylosis. ICD-10-CM Diagnosis Code M43.25. Fusion of spine, thoracolumbar region. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code. ICD-10-CM Diagnosis Code Z48.89 [convert to ICD-9-CM] Encounter for other specified surgical aftercare.
· Fusion of spine, lumbar region. M43.26 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M43.26 became effective on October 1, 2021.
Encntr for surgical aftcr fol surgery on the nervous sys; encounter for surgical aftercare following surgery on the sense organs (Z48.810) ICD-10-CM Diagnosis Code Z48.811. Encounter for surgical aftercare following surgery on the nervous system. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code POA Exempt.
Valid for SubmissionICD-10:Z98.1Short Description:Arthrodesis statusLong Description:Arthrodesis status
Other specified postprocedural states The 2022 edition of ICD-10-CM Z98. 89 became effective on October 1, 2021.
ICD-10-CM Code for Encounter for other orthopedic aftercare Z47. 89.
Aftercare codes are found in categories Z42-Z49 and Z51. Aftercare is one of the 16 types of Z-codes covered in the 2012 ICD-10-CM Official Guidelines and Reporting.
Arthrodesis refers to the fusion of two or more bones in a joint. In this process, the diseased cartilage is removed, the bone ends are cut off, and the two bone ends are fused into one solid bone with metal internal fixation.
Not Valid for SubmissionICD-10:Z98.89Short Description:Other specified postprocedural statesLong Description:Other specified postprocedural states
ICD-10-CM Code for Encounter for surgical aftercare following surgery on the nervous system Z48. 811.
Use Z codes to code for surgical aftercare. Z47. 89, Encounter for other orthopedic aftercare, and. Z47. 1, Aftercare following joint replacement surgery.
1, we need to report first Z47. 89 Encounter for other orthopedic aftercare, as the Primary diagnosis followed by Z98.
Aftercare for injuries during the healing and recovery phase should be coded with the injury code and the appropriate 7th character for subsequent encounters rather than a Z code. An example would be aftercare for an unspecified fracture of the lower end of the right humerus.
Follow-up. The difference between aftercare and follow-up is the type of care the physician renders. Aftercare implies the physician is providing related treatment for the patient after a surgery or procedure. Follow-up, on the other hand, is surveillance of the patient to make sure all is going well.
Code Z47. 81 (encounter for orthopaedic aftercare following surgical amputation) is used for visits following a surgical amputation and must be accompanied by an additional code that identifies the amputated limb (Table 2).
The codes for the anterior spinal fusion are 0SG00AJ (L4-L5) and 0SG30AJ (L5-S1) . Two codes are also assigned for the posterior spinal fusion, 0SG0071 (L4-L5) and 0SG3071 (L5-S1) . Codes 0SB20ZZ and 0SB40ZZ are also assigned for the discectomy performed at two different levels of the spine. Lastly, code 0QB20ZZ is assigned for the harvesting of the right iliac crest bone graft.
If an interbody fusion device is used (alone or containing other material like bone graft), the procedure is coded with the device value Interbody Fusion Device (A)
The code for this procedure is 0QB20ZZ, with the body part character (fourth character) being 2 for right pelvic bone. The iliac crest does not have its own distinct body part value in ICD-10-PCS, with the ICD-10-PCS Body Part Key indicating that the pelvic bone is the closest proximal branch.
If a mixture of autologous and nonautologous bone graft (with or without biological or synthetic extenders or binders) is used, the procedure is coded with device value Autologous Tissue Substitute (7)
If the operative report documents that a discectomy is performed , the correct root operation is Excision. However, if the operative report documents a “total discectomy,” the root operation is Resection.
The implementation of ICD-10-PCS has enhanced the skills of coding professionals as it contains many unique features that provide an opportunity to accurately reflect the complexity of the procedures being performed. The assignment of ICD-9-CM procedure codes for spinal fusions often challenged coding professionals, and this has not changed with the transition to ICD-10-PCS. As with the coding of other complex surgical procedures, coding professionals struggle with identifying which portion of the spinal fusion procedure to code or not to code.
Qualifier: The qualifier character identifies the column of the spine being fused (anterior or posterior) and if the surgical approach is from the front or back of the body (see Figure 1 below).
Aftercare codes are found in categories Z42-Z49 and Z51. Aftercare is one of the 16 types of Z-codes covered in the 2012 ICD-10-CM Official Guidelines and Reporting. Aftercare visit codes cover situations occurring when the initial treatment of a disease has been performed and the patient requires continued care during the healing or recovery phase, or care for the long-term consequences of the disease.
When the reason for an encounter is aftercare following a procedure or injury, the 2012 ICD-10-CM Official Guidelines and Reporting should be consulted to ensure that the correct code is assigned. Codes for reporting most types of aftercare are found in Chapter 21. However, aftercare related to injuries is reported with codes from Chapter 19, using seventh-character extensions to identify the service as aftercare.
Aftercare following explantation of a joint prosthesis is reported with a code from category Z47, denoting orthopedic aftercare. Aftercare following explantation of a joint prosthesis (Z47.3-) may be reported for a staged procedure or an encounter for evaluation of planned insertion of a new joint prosthesis following prior explantation of a joint prosthesis. In ICD-10-CM, aftercare for explantation of a joint prosthesis is specific to site.
Aftercare for injuries is reported with a V-code in ICD-9-CM. However, aftercare of injuries in ICD-10-CM is captured with the seventh character “D,” specifically denoting routine care following most injuries. For fractures, additional seventh characters for subsequent encounters apply, depending on whether the fracture is open or closed and whether the healing is routine or delayed, with nonunion or malunion.
Reason for encounter: Aftercare for traumatic fracture is reported with code S82.224D, Nondisplaced transverse fracture of shaft of right tibia, subsequent encounter for closed fracture with routine healing.
Codes for encounters for antineoplastic radiation, chemotherapy and immunotherapy (Z51.0, Z51.1-) are assigned if the sole reason for the encounter is antineoplastic therapy – even if the patient still has the neoplastic disease.
Aftercare codes should be used in conjunction with other aftercare codes, diagnosis codes and/or other categories of Z-codes to provide better detail on the specifics of the aftercare encounter/visit, unless otherwise directed by the classification.
Remember, there are a number of orthopedic aftercare codes for specific surgeries—all of which you can find in the ICD-10 tabular list under Z47, Orthopedic aftercare.
Z codes also apply to post-op care when the condition that precipitated the surgery no longer exists —but the patient still requires therapeutic care to return to a healthy level of function. In situations like these, ICD-10 provides a few coding options, including:
For example, if you were treating a patient who had a total knee replacement, you would want to submit Z47.1, Aftercare following joint replacement surgery, as well as Z96.651 (to indicate that the joint replaced was the knee). Taking this one step further, let’s say the patient was receiving treatment for gait abnormality following a total knee replacement of the right knee due to osteoarthritis in that knee. Let’s also assume that, as a result of the surgery, the patient is no longer suffering from osteoarthritis. The appropriate codes for this scenario, according to this presentation, would be:
If the line between acceptable and unacceptable uses of aftercare codes still seems a bit fuzzy, just remember that in most cases, you should only use aftercare codes if there’s no other way for you to express that a patient is on the “after” side of an aforementioned “before-and-after” event.
ICD-10 introduced the seventh character to streamline the way providers denote different encounter types—namely, those in volving active treatment versus those involving subsequent care. However, not all ICD-10 diagnosis codes include the option to add a seventh character. For example, most of the codes contained in chapter 13 of the tabular list (a.k.a. the musculoskeletal chapter) do not allow for seventh characters. And that makes sense considering that most of those codes represent conditions—including bone, joint, or muscle conditions that are recurrent or resulting from a healed injury—for which therapy treatment does progress in the same way it does for acute injuries.
In situations where it’s appropriate to use Z codes, “aftercare codes are generally the first listed diagnosis,” Gray writes. However, that doesn’t mean the Z code should be the only diagnosis code listed for that patient.
In situations where it’s appropriate to use Z codes, aftercare codes may be listed as the primary diagnosis—but that doesn’t mean the Z code should be the only diagnosis code listed for that patient. In fact, you should submit secondary codes—including other Z codes—when they can help you fully describe the patient’s situation in the most specific way possible.
Pseudoarthrosis — this is referred to as non-union and means ‘false joint’. This is the result of a failed spinal fusion. Radiculopathy— referred to as pinched nerve in the spine. Myelopathy— is a very serious condition and can cause permanent spinal cord injury. Myelopathy is caused from severe pressure on the spinal cord from spinal stenosis, ...
Most Common Diagnoses Associated With The Need For Spinal Fusion: Degenerative disc disease (DDD) (disc degeneration)— often causes weakness, numbness and pain. DDD is age-related and is when one or more of the discs between the vertebrae of the spinal column breaks down or deteriorates. DDD is not a true disease but develops with aging.
The vertebrae are stacked on top of each other and create the natural curvature of the back.
Spinal stenosis occurs most often in the lumbar and cervical spine. The narrowing causes pressure on the nerves throughout the spine. Most spinal stenosis diagnoses occur due to something happening to narrow the spine, but can be due to being born with a small spinal canal (not common).
Spinal fusion coding is a tough job for coders. There are so many diseases/disorders that result in the need for spinal fusion, and even more choices in reporting the ICD-10-PCS codes. The spine has many demands as it holds up your head, shoulders and upper body.