Osteopathic procedure codes have a first character value of "7". The body system character contains the value anatomical regions. There is only one root operation in the osteopathic section. Treatment: Manual treatment to eliminate or alleviate somatic dysfunction and related disorders
The Manipulation root operation is identified by the character code B in the 3 rd position of the procedure code. It is defined as Manual procedure that involves a directed thrust to move a joint past the physiological range of motion, without exceeding the anatomical limit. The 4 th character refers to the body part or body region.
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.
When combinations of devices are used on the same vertebral joint, the device value coded for the procedure is as follows: 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)
Osteopathic procedure codes have a first character value of "7". The body system character contains the value anatomical regions. There is only one root operation in the osteopathic section.
The fourth character specifies the body region on which the osteopathic manipulation is performed. The approach for osteopathic manipulations is always External. The sixth character specifies the method by which the manipulation is accomplished.
The decision to utilize OMT is typically made on a visit-by-visit basis, requiring the physician to re-evaluate the patient on subsequent encounters to determine if OMT will be beneficial.
Always separate your E/M services from the procedure note. Your documentation should identify that a separate and significant E/M was performed the same day as the OMT.
CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
This article contains coding and other guidelines that complement the local coverage determination (LCD) for Osteopathic Manipulative Treatment.
The correct use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in the related determination.
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.
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.
The ICD-10 Procedure Coding System (ICD-10-PCS) is a catalog of procedural codes used by medical professionals for hospital inpatient healthcare settings. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates. These 2022 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2021 through September 30, 2022.
releasing yearly updates. These 2021 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2020 through September 30, 2021.
7W07X2Z is a billable procedure code used to specify the performance of osteopathic treatment of upper extremities using general mobilization. The code is valid for the year 2021 for the submission of HIPAA-covered transactions.
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Osteopathic manipulative treatment (OMT) is a treatment employed, primarily by osteopathic physicians, to facilitate a patient’s recovery from somatic dysfunction, defined under the American Osteopathic Association’s Glossary of Terminology as: impaired or altered function of related components of the somatic (body framework) system: skeletal, arthroidal and myofascial structures and related vascular, lymphatic and neuroelements.
Any diagnosis not listed in the "ICD-10 Codes That Support Medical Necessity" section.
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.
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.
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 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 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 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)
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).