icd 10 code for lumbar spinal fusion

What is a lumbar spine fusion?

Oct 01, 2021 · 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.

What is spinal lumbar?

May 06, 2019 · The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Lumbar Spinal Fusion L37848. Coding Information CPT/HCPCS Codes Expand All | Collapse All Group 1 (5 Codes) Group 1 Paragraph N/A Group 1 Codes CPT/HCPCS Modifiers N/A ICD-10-CM Codes that Support Medical Necessity

What to do with lumbar spinal stenosis?

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. Orthopedic aftercare; Orthopedic aftercare done; Removal of cast; Removal of cast done.

What is complete spinal fusion?

Oct 01, 2021 · ICD-10-CM Code M43.26 Fusion of spine, lumbar region Billable Code M43.26 is a valid billable ICD-10 diagnosis code for Fusion of spine, lumbar region . It is found in the 2022 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2021 - Sep 30, 2022 .

How do you code a spinal fusion in ICD 10 PCS?

Two codes are assigned for the anterior spinal fusion, as two levels of the spine were fused (L4-L5 and L5-S1). 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).

What is the ICD 10 code for aftercare following spinal fusion?

Z48.811ICD-10-CM Code for Encounter for surgical aftercare following surgery on the nervous system Z48. 811.

What is the CPT code for lumbar fusion?

A: You should report CPT code 22612 for the spinal fusion.Sep 28, 2018

What is the ICD 10 code for lumbar laminectomy?

The ICD-10-CM code M96. 1 might also be used to specify conditions or terms like cervical post-laminectomy syndrome, lumbar post-laminectomy syndrome, post-laminectomy syndrome or thoracic post-laminectomy syndrome.

What is the ICD-10 code for aftercare following orthopedic surgery?

ICD-10-CM Code for Encounter for other orthopedic aftercare Z47. 89.

Is a kyphoplasty a fusion?

The goal of the surgery is to fuse and repair the fracture, eliminate back pain, and restore posture and ease of movement. The most common surgical procedures for spinal compression fractures are lumbar fusion and vertebroplasty/kyphoplasty. In a lumbar fusion, the vertebrae are connected with rods.

What is the difference between CPT code 63030 and 63047?

CPT Code 63030 is defined as laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; one interspace, lumbar (including open or endoscopically-assisted approach) and; Code 63047, laminectomy, facetectomy and ...Jan 2, 2016

What is the difference between CPT 22630 and 22633?

Code 22630 describes a posterior lumbar interbody arthrodesis, also known as fusion. Code 22633 describes a posterior lumbar interbody fusion and a posterolateral fusion performed at the same interspace and segment (also called spinal level, such as L4-L5).Jun 1, 2016

What is the difference between CPT code 22551 and 22554?

Use code 22551 for the 1st level of fusion and discectomy performed and add-on code 22552 for subsequent levels. Codes 63075 and 22554 are still valid for use in cases where only those individual procedures are performed and they are not combined.Apr 18, 2011

Is a laminectomy the same as a spinal fusion?

Laminectomy (removal of lamina bone) and diskectomy (removing damaged disk tissue) are both types of spinal decompression surgery. Your provider may perform a diskectomy or other techniques (such as joining two vertebrae, called spinal fusion) during a laminectomy procedure.Jan 11, 2021

What is the ICD-10 code for history of spinal fusion?

Z98. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

What is the ICD-10 code for laminectomy status?

M96.1ICD-10-CM Code for Postlaminectomy syndrome, not elsewhere classified M96. 1.

General Information

CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833 (e) prohibits Medicare payment for any claim lacking the necessary information to process that claim

Article Guidance

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Lumbar Spinal Fusion L37848.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

Dissection of a Spinal Fusion Code

Body Part: The body part character reflects the level of the vertebrae (cervical, thoracic, lumbar and/or sacral) and the number of vertebral joints fused. The intervertebral joint is the space that is located between any two adjacent vertebrae. One factor in determining the number of fusion codes to assign is how many levels were fused.

Integral versus Non-Integral

Coding professionals must be able to distinguish between what procedures are integral to a spinal fusion and are not assigned additional codes, versus those not considered to be integral and are assigned separate codes. The following are examples of how to make that distinction.

What is the ICd 10 code for fusion of spine?

M43.26 is a valid billable ICD-10 diagnosis code for Fusion of spine, lumbar region . It is found in the 2021 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2020 - Sep 30, 2021 .

Do you include decimal points in ICD-10?

DO NOT include the decimal point when electronically filing claims as it may be rejected. Some clearinghouses may remove it for you but to avoid having a rejected claim due to an invalid ICD-10 code, do not include the decimal point when submitting claims electronically. See also:

What are the two regions of the vertebrae that are fused together?

This is because the fusion includes two regions within the vertebrae (lumbar and lumbosacral). As above, this is only two vertebral joints being fused together but of two different regions (lumbar and lumbosacral).

How many vertebrae are in the spinal column?

Level (s) of the spinal column and number being fused: As you can see in the picture below, the human vertebral column consists of 33 vertebrae divided into five regions: When reviewing the operative note, look for what level (s) are being fused together. A level involves two vertebrae and the space between them (interspace) containing the disc.

Is a lumbar fusion counted as one level?

When the surgeon documents that a fusion consisted of only two vertebrae and they are of the same level (such as lumbar) then this is counted as only one level. However, in the same procedure if the surgeon also performs a fusion of another level (such as sacrum), this part of the fusion would also need to be reported.