ICD-10 code M43. 26 for Fusion of spine, lumbar region is a medical classification as listed by WHO under the range - Dorsopathies .
Fusion: Root Operation G The body part value assigned is the specific joint being fused. When coding a spinal fusion at L1-L2, the body part value used is “0-Lumbar vertebral joint,” meaning one joint.
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).
Other specified postprocedural states The 2022 edition of ICD-10-CM Z98. 89 became effective on October 1, 2021.
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.
Root operations that take out some or all of a body part include Excision, Resection, Detachment, Destruction, and Extraction. Root operations that take out solids/fluids/gases from a body part include Drainage, Extirpation, and Fragmentation.
CPT code 22633 is defined as “Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and level; lumbar.” CPT code 22634 should be reported for each ...
CPT® Code 22630 in section: Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace.
CPT® Code 22842 in section: Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires)
Status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to current facility. Z92. 82 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 Z92.
Z98.1Z98. 1 - Arthrodesis status. ICD-10-CM.
1: Postlaminectomy syndrome, not elsewhere classified.
There's no significant difference in the success rate of the surgeries. However, PLIF can be riskier as the vertebrae and spinal cord must be moved. ALIF works around large blood vessels, which can be dangerous. Each procedure comes with risks that will be explained by the surgeon.
ALIF is a very well tolerated procedure, and typically is associated with less pain and a faster recovery than spinal fusion surgery performed from the back of the spine. It allows placement of a much larger cage than other types of spinal fusion, which provides more stability and has a higher chance of fusing solidly.
PLIF can happen if the damage is more comfortable to access from the back. With ALIF, the doctor has a broader view of the spine and more surface area to work with. This makes ALIF the better option if more than one fusion is needed. PLIF may have fewer incisions, but the risks increase with direct access to the spine.
Incision. To gain access to the vertebrae being fused, the surgeon makes an incision in one of three locations: in your neck or back directly over your spine, on either side of your spine, or in your abdomen or throat so that your surgeon can access the spine from the front.
If the bone for the graft comes from a bone bank or donor other than the patient, it is an allograft. The spinal allograft codes are: Like 20936-20938, the allograft codes include shaping or preparation of the graft material. 2.
You may report a maximum of one unit of any spinal bone graft code, per session, even if the surgeon places multiple spinal bone grafts. CPT® Assistant (April 2012) instructs, “When more than one type of bone graft is required, the appropriate code (s) from the 20930-20938 series are reported only once per operative session, regardless of the number of vertebral levels being surgically fused (i.e., not once per spinal interspace or segment fused).” For this same reason, you should never append modifier 50 Bilateral procedure to bone graft codes 20930-20938.
Morselized bone grafts are small pieces of bone used to pack defects and to promote new bone growth. For a morselized autograft, choose 20937. For a morselized allograft, select 20930.
CPT - In CPT, discectomy solely to prepare the vertebra for fusion is included in the description of the spinal fusion code and is therefore considered integral to the fusion procedure. Discectomy in the same interspace where the fusion it taking place, and which requires additional work for the purpose of completing spinal decompression, ...
Spinal fusion procedures are performed to treat a variety of conditions. It’s common to see the diagnoses in the list below as the pre/post-operative diagnosis for a spinal fusion procedure.
Some of the biggest differences between CPT and ICD-10-PCS code assignment for spinal fusion are related to coding for the accessory procedures that may or may not be separately reportable depending on the code set you are using. Determining if these procedures should be coded and assigning the correct codes when needed will depend on a careful and thorough review of the operative report documentation to identify critical details that impact code assignment.
ICD-10-PCS – In ICD-10-PCS the use bone graft is indicated by the Device character. Selection of the appropriate character value is influenced by the type of graft (auto, nonauto or synthetic) and whether the graft was used alone or in combination with an interbody fusion device.
When circumstances call for coding the same procedure in both CPT and ICD-10-PCS, a number of variables can make it challenging to get the coding right. For instance, the rules and guidelines that dictate whether an accessory procedure is integral to the primary procedure or separately reportable vary with the type of codes you are using.
ICD-10-PCS – If facilities decide to collect the information, insertion of BMP is separately reportable with a code from the Administration Section of ICD-10-PCS.
Although accompanying instrumentation or fixation devices may be used in spinal fusion procedures, their use is not technically required for the procedure to be considered a fusion, as spinal fusion may be achieved via the placement of bone graft or bone graft substitute alone.
You should report any spinal graft code only once per procedure , regardless of how many areas the surgeon treats with that same type of graft. Note that all spinal bone grafting codes 20930-20938 include graft shaping or preparation, when required, and all autograft codes include graft harvesting. You would not code separately for either ...
Codes 22554-22585 and 22630-22632 describe scrapping away of the disk just enough to make room for graft material.