Fusion of spine, lumbar region. Fusion of lumbar spine; Lumbar spine ankylosis. ICD-10-CM Diagnosis Code M43.26. 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.
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.
Oct 01, 2021 · Z47.89 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 Z47.89 became effective on October 1, 2021. This is the American ICD-10-CM version of Z47.89 - other international versions of ICD-10 Z47.89 may differ.
Oct 01, 2021 · Fusion of spine, lumbar region. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code. 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.
ICD-10: | Z98.1 |
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Short Description: | Arthrodesis status |
Long Description: | Arthrodesis status |
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.
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.
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 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.
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)
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).
As with Examples #1 and #2, the segmental instrumentation is included in the spinal fusion and is not coded separately. The lumbar decompression L4-L5 and L5-S1 bilateral foraminotomies and L3 decompression laminectomy are also considered to be integral to the spinal fusion and not coded separately.
Z47.82 is a billable diagnosis code used to specify a medical diagnosis of encounter for orthopedic aftercare following scoliosis surgery. The code Z47.82 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)
Scoliosis causes a sideways curve of your backbone, or spine. These curves are often S- or C-shaped. Scoliosis is most common in late childhood and the early teens, when children grow fast. Girls are more likely to have it than boys.
Your surgeon can tell you how you might feel and what you will be able to do - or not do - the first few days, weeks, or months after surgery. Some other questions to ask are
After any operation, you'll have some side effects. There is usually some pain with surgery. There may also be swelling and soreness around the area that the surgeon cut. Your surgeon can tell you which side effects to expect.
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.
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.
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:
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.