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Prolapsed lumbar intervertebral disc; ICD-10-CM M51.26 is grouped within Diagnostic Related Group(s) (MS-DRG v 38.0): 551 Medical back problems with mcc; 552 Medical back problems without mcc; Convert M51.26 to ICD-9-CM. Code History. 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM) 2017 (effective 10/1/2016): No change
discectomy harvesting of bone graft And the codes are 0SG00AJ (L4-L5) and 0SG30AJ (L5-S1) for the transforaminal lumbar interbody fusion 0SG0071 (L4-L5) and 0SG3071 (L5-S1) posterior spinal fusion 0SB20ZZ and 0SB40ZZ discectomy at 2 levels 0QB20ZZ for harvesting of bone graft #5 Posterior Cervical Fusion and Instrumentation, C5-T1
This would be reported with two ICD-10-PCS codes. One for the lumbar discectomy (excision at L3 and L5 interspaces) and one for the lumbosacral discectomy (excision L5-S1 interspace). Even though two lumbar vertebral discs (L3-L4 and L4-L5) were excised this is only reported once.
Excision of Lumbosacral Disc, Open Approach 2016 2017 2018 2019 2020 2021 Billable/Specific Code ICD-10-PCS 0SB40ZZ is a specific/billable code that can be used to indicate a procedure.
2022 ICD-10-CM Diagnosis Code M96. 1: Postlaminectomy syndrome, not elsewhere classified.
ICD-10 code M43. 26 for Fusion of spine, lumbar region is a medical classification as listed by WHO under the range - Dorsopathies .
Release Lumbar Spinal Cord, Open Approach ICD-10-PCS 00NY0ZZ is a specific/billable code that can be used to indicate a procedure.
The code for the posterior lumbar fusion is 0SG107J, with the device value being 7 for autologous substitute. The code for the discectomy is 0SB20ZZ, with the root operation being Excision. If the operative report documents that a discectomy is performed, the correct root operation is Excision.
Other intervertebral disc displacement, lumbar region M51. 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 M51. 26 became effective on October 1, 2021.
Lumbar discectomy is a type of surgery to fix a disc in the lower back. This surgery uses smaller cuts (incisions) than an open lumbar discectomy. Your backbone, or spinal column, is made up of a chain of bones called the vertebrae. Your spinal cord runs through the spinal column.
63005 Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (e.g., spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis.
ICD-10-CM Code for Postlaminectomy syndrome, not elsewhere classified M96. 1.
Cervical laminectomy It usually involves removing a small piece of the back part (lamina) of the small bones of the spine (vertebrae). Laminectomy enlarges the spinal canal to relieve pressure on the spinal cord or nerves. Laminectomy is often done as part of a decompression surgery.
360-degree lumbar fusion is also known as an Anterior/Posterior Lumbar fusion. The procedure is an extremely common method for fusing the lumbar spine in which there is an incision anterior in the abdominal area and incisions posterior in the lumbar or low back region.
Spine Disorders A Transforaminal Interbody Lumbar Fusion is a particular type of fusion, or surgical procedure that permanently fuses, or unites, bones of the spine. The fusion is achieved using bone graft: bone material either acquired from a bone bank or transplanted from elsewhere in the patient's own body.
Spinal fusion is surgery to permanently join together two or more bones in the spine so there is no movement between them. These bones are called vertebrae. Abnormal curvature in the spine is known as scoliosis, and generally begins just at the onset of puberty and progresses during the period of rapid growth.
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.
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.
Common areas of confusion include CPT code 63042. Re-exploration at a level with a recurrent disc herniation can only use CPT code 63042. It should only be used after the global period for the first disc surgery has expired. Repeat facetectomy and lateral recess decompression at a level with a prior decompression must use CPT code 63047 if no disc work is per-formed. The presence of a lumbar disc herniation (722.1) drives the CPT code.Another common misconception is code 63047. This code can be used unilaterally or bilaterally as long as the decompression involves the lateral recess and foramen. Posterior fusion codes that involve disc preparation (22630,22633) already take into account the decompression work. Using ad-ditional decompression codes (63005, 63012, 63030,63042, 63047) is not al-lowed.
The use of posterior fusion codes that encompass disc work (eg, 22630 and 22633) already take into account the removal of lamina, facets and ligamen-tum flavum. The interbody fusion codes also were written assuming bilateral interbody placement which requires bilateral decompression. In cases that require decompression plus fusion (L4-5 spondylolisthesis with central and lateral recess stenosis), only the fusion codes can be used.
2014 Common Coding Scenarios for Comprehensive Spine Care includes medical and surgical coding vignettes, key components to include in the procedure notes and proper coding of spine procedures for 2014.
Decompression is the general term to describe removal of the spinal disk, bone, or tissue causing pressure and pain. Often, this is the only procedure performed. Examples include: laminectomy to decompress spinal canal and/or nerve roots (e.g., 63001-63017, 63045-+63048), discectomy to decompress spinal canal and/or nerve roots (e.g., 63020-+63035, 63040-+63044, 63055-+63057), corpectomy (e.g., 63081-+63091), fracture repair (e.g., 22325-+22328), etc.#N#CPT® designates the decompression codes as being per “vertebral segment” or per “interspace.” Decompression occurs at the interspace for discectomy codes (e.g., right L4-L5 interspace). Discectomy is a single, standalone code, such as 63030 Laminotomy (hemilaminectomy), with decompression of nerve root (s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar.#N#But decompression of the spinal canal can be coded per vertebral segment (63001-63017), or per level of foraminotomy (e.g., decompression of the L4 exiting nerve root via partial laminectomy at L4 and partial laminectomy at L5, with foraminotomy at L4-L5, is reported using one code: 63047 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root [s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar).#N#Discern whether the approach was posterior or anterior to choose the correct code. Table A illustrates commonly used, standalone decompression codes for spine surgery.#N#Table A: Standalone decompression codes for spine surgery
Some payers (including Medicare) will incorrectly reimburse the instrumentation and some bone graft codes when billed with modifier 62; however, CPT® guidelines prohibit reporting the instrumentation and bone graft codes with modifier 62. Example 1.
Because a fusion was performed, you must include a bone graft code. As with other graft codes in CPT®, the spinal bone graft codes are reported for harvesting the bone graft. The work of placing the bone graft is included in the arthrodesis/fusion codes. All spinal bone graft codes are add-on codes.
“It seems like coding spine cases is as complicated as doing the surgery,” said a spine surgeon at his first coding training session with me.#N#Spine procedure coding can make even the most confident coder squirm. But spine procedure coding doesn’t have to be difficult. In fact, it’s quite formulaic. Follow these five principles and spine procedure coding will go from scary to simple.
Kim Pollock, RN, MBA, CPC, CMDP, is a senior consultant and speaker with Karen Zupko & Associates, Inc., a physician practice management consulting and training firm based in Chicago, Ill. She is on the faculty for the American Association of Neurological Surgeons coding and reimbursement courses. Pollock has recently co-authored the book The Essential Guide to Coding in Otolaryngology.