CERVICAL PROCEDURES PHYSICIAN CODING

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "CERVICAL PROCEDURES PHYSICIAN CODING"

Transcription

1 CERVICAL PROCEDURES PHYSICIAN CODING Anterior Cervical Discectomy with Interbody Fusion (ACDF) Anterior interbody fusion, with discectomy and decompression; cervical below C first interspace each additional interspace Anterior Instrumentation vertebral segments vertebral segment or more vertebral segments Note: Do not report or with or even if performed by different physicians. To report anterior cervical discectomy and interbody fusion at the same level during the same session, use Cervical Arthroplasty Total Disc Arthroplasty, Anterior Approach, Cervical single interspace Laminoplasty Laminoplasty, Cervical two or more vertebral segments With Reconstruction Current Procedural Terminology (CPT ) copyright 2011 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Zimmer Coding Reference Guide Disclaimer The information in this document was obtained from third party sources and is subject to change without notice, including as a result in changes in reimbursement laws, regulations, rules and policies. All content in this document is informational only, general in nature and does not cover all situations or all payers rules or policies. The service and the product must be reasonable and necessary for the care of the patient to support reimbursement. Providers should report the procedure and related codes that most accurately describe the patients medical condition, procedures performed and the products used. This document represents no promise or guarantee by Zimmer regarding coverage or payment for products or procedures by Medicare or other payers. Providers should check Medicare bulletins, manuals, program memoranda, and Medicare guidelines to ensure compliance with Medicare requirements. Inquiries can be directed to the hospital s Medicare Part A fiscal intermediary, the physician s Medicare Part B carrier, or to appropriate payers. Zimmer specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information in this document. For further assistance with coding questions, contact the Zimmer Reimbursement Hotline at

2 CERVICAL PROCEDURES FACILITY CODING Anterior Cervical Discectomy with Interbody Fusion (ACDF) with Anterior Plate Anterior column fusion, anterior approach, cervical (C2 level or below) Discectomy Insertion of interbody spinal fusion device Fusion or refusion of 2-3 vertebrae (or) Fusion or refusion of 4-8 vertebrae Excision of bone for graft, other harvested from the iliac crest or locally Intra-operative monitoring Note: Instrumentation is included in the fusion code and not reported separately. If structural allograft is used, do not report code Allograft is included in the fusion code and not separately reported. Cervical Arthroplasty Cervical arthroplasty Laminoplasty Other exploration and decompression of spinal canal The information in this document was obtained from third party sources and is subject to change without notice, including as a result in changes in reimbursement laws, regulations, rules and policies. All content in this document is informational only, general in nature and does not cover all situations or all payers rules or policies. The service and the product must be reasonable and necessary for the care of the patient to support reimbursement. Providers should report the procedure and related codes that most accurately describe the patients medical condition, procedures performed and the products used. This document represents no promise or guarantee by Zimmer regarding coverage or payment for products or procedures by Medicare or other payers. Providers should check Medicare bulletins, manuals, program memoranda, and Medicare guidelines to ensure compliance with Medicare requirements. Inquiries can be directed to the hospital s Medicare Part A fiscal intermediary, the physician s Medicare Part B carrier, or to appropriate payers. Zimmer specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information in this document. For further assistance with coding questions, contact the Zimmer Reimbursement Hotline at Page 2 of 15

3 LUMBAR PROCEDURES PHYSICIAN CODING Anterior Lumbar Interbody Fusion (ALIF) with Posterior Instrumentation Anterior Interbody Fusion, Lumbar first interspace each additional interspace Application of Biomechanical Device (cages, etc.) first interspace, if applicable each additional interspace Posterior Instrumentation non-segmental instrumentation segmental; 3 6 vertebral segments segmental; 7 12 vertebral segments segmental; 13+ vertebral segments ALIF with Anterior Instrumentation Anterior Interbody Fusion, Lumbar first interspace each additional interspace Application of Biomechanical Device (cages, etc.) first interspace, if applicable each additional interspace Anterior Instrumentation vertebral segments vertebral segments or more vertebral segments Page 3 of 15

4 ALIF and Posterolateral Fusion (Classic 360 Procedure) Posterolateral Fusion, Lumbar first level each additional segment Anterior Interbody Fusion, Lumbar first interspace each additional interspace Posterior Instrumentation non-segmental instrumentation segmental; 3 6 vertebral segments segmental; 7 12 vertebral segments segmental; 13+ vertebral segments Application of Biomechanical Device (cages, etc.) for first interspace, if applicable each additional interspace Posterior Lumbar Interbody Fusion (PLIF) or Transforaminal Lumbar Interbody Fusion (TLIF) with Posterior Instrumentation Posterior Interbody Fusion, Lumbar first interspace each additional interspace Application of Biomechanical Device (cages, etc.) first interspace, if applicable each additional interspace Posterior Instrumentation non-segmental instrumentation segmental; 3 6 vertebral segments segmental; 7 12 vertebral segments segmental; 13+ vertebral segments Note: Codes and are bundled per the NCCI edits with code CPT Assistant (January 2001, page 12) states that these codes can be reported in addition to the fusion code if performed for decompression (apply modifier-59 to the decompression code in this instance.) Page 4 of 15

5 Laminectomy, Lumbar Laminectomy without facetectomy, foraminotomy or one or two vertebral segments discectomy,lumbar, except for spondylolisthesis more than 2 vertebral segments Laminectomy with removal of abnormal facets and/or Gill-type procedure pars interarticularis with decompression, for spondylolisthesis, lumbar Laminotomy (hemilaminectomy), including partial one interspace facetectomy, foraminotomy and/or excision of herniated disc, lumbar each additional interspace Laminotomy (hemilaminectomy), including partial one interspace facetectomy, foraminotomy and/or excision of herniated disc, re-exploration, lumbar each additional interspace Laminectomy, facetectomy and foraminotomy, lumbar single vertebral segment each additional segment PLIF/TLIF and Posterolateral Fusion (Single Incision 360 ) Combined fusion, posterolateral fusion, with posterior first interspace and segment interbody fusion each additional interspace/segment Posterior Instrumentation non-segmental instrumentation segmental; 3 6 vertebral segments segmental; 7 12 vertebral segments segmental; 13+ vertebral segments Application of Biomechanical Device (cages, etc.) first interspace, if applicable each additional interspace Note: Codes and are bundled per the NCCI edits with code CPT Assistant (January 2001, page 12) states that these codes can be reported in addition to the fusion code if performed for decompression (apply modifier -59 to the decompression code in this instance). Page 5 of 15

6 Direct Lateral Fusion with Anterior Instrumentation (DLIF) Anterior Interbody Fusion, Lumbar first interspace each additional interspace Application of Biomechanical Device (cages, etc.) first interspace, if applicable each additional interspace Anterior Instrumentation vertebral segments vertebral segments or more vertebral segments Posterolateral Fusion with Posterior Instrumentation Posterolateral Fusion, Lumbar first level each additional segment Posterior Instrumentation non-segmental instrumentation segmental; 3 6 vertebral segments segmental; 7 12 vertebral segments segmental; 13+ vertebral segments Percutaneous Vertebroplasty Percutaneous vertebroplasty, one vertebral body, thoracic unilateral, or bilateral injection lumbar each additional level Note: Imaging guidance is reported separately when performed. Report code for fluoroscopic guidance or for CT guidance. Page 6 of 15

7 Percutaneous Vertebral Augmentation Percutaneous vertebral augmentation, including cavity thoracic creation (fracture reduction and bone biopsy included when performed) using mechanical device, one vertebral body, unilateral or bilateral cannulation (e.g., kyphoplasty) lumbar each additional level Note: Imaging guidance is reported separately when performed. Report code for fluoroscopic guidance or for CT guidance. Discectomy, Lumbar Posterior Discectomy, Lumbar first interspace each additional interspace Note: If procedure is performed bilaterally, use modifier 50. Current Procedural Terminology (CPT ) copyright 2011 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Zimmer Coding Reference Guide Disclaimer The information in this document was obtained from third party sources and is subject to change without notice, including as a result in changes in reimbursement laws, regulations, rules and policies. All content in this document is informational only, general in nature and does not cover all situations or all payers rules or policies. The service and the product must be reasonable and necessary for the care of the patient to support reimbursement. Providers should report the procedure and related codes that most accurately describe the patients medical condition, procedures performed and the products used. This document represents no promise or guarantee by Zimmer regarding coverage or payment for products or procedures by Medicare or other payers. Providers should check Medicare bulletins, manuals, program memoranda, and Medicare guidelines to ensure compliance with Medicare requirements. Inquiries can be directed to the hospital s Medicare Part A fiscal intermediary, the physician s Medicare Part B carrier, or to appropriate payers. Zimmer specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information in this document. For further assistance with coding questions, contact the Zimmer Reimbursement Hotline at Page 7 of 15

8 LUMBAR PROCEDURES FACILITY CODING Anterior Lumbar Interbody Fusion (ALIF) with Instrumentation Anterior column fusion, anterior approach, lumbar anterior interbody fusion Fusion or refusion of 2-3 vertebrae (or) Fusion or refusion of 4-8 vertebrae (or) Fusion or refusion of 9 or more vertebrae Discectomy Insertion of interbody spinal fusion device Excision of bone for graft, other harvested from the iliac crest or locally Note: Instrumentation is included in the fusion code and not reported separately. If structural allograft is used, do not report code Allograft is included in the fusion code and not separately reported. Posterior Lumbar Interbody Fusion (PLIF) or Transforaminal Lumbar Interbody Fusion (TLIF) with Posterior Instrumentation Anterior column fusion, posterior approach, lumbar posterior interbody fusion Fusion or refusion of 2-3 vertebrae (or) Fusion or refusion of 4-8 vertebrae (or) Fusion or refusion of 9 or more vertebrae Discectomy Insertion of interbody spinal fusion device Excision of bone for graft, other harvested from the iliac crest or locally Intra-operative monitoring Note: Instrumentation is included in the fusion code and not reported separately. If structural allograft is used, do not report code Allograft is included in the fusion code and not separately reported. Posterolateral Fusion with Posterior Instrumentation Posterior column fusion, posterior approach, lumbar posterolateral fusion Fusion or refusion of 2-3 vertebrae (or) Fusion or refusion of 4-8 vertebrae (or) Fusion or refusion of 9 or more vertebrae Excision of bone for graft, other harvested from the iliac crest or locally Intra-operative monitoring Note: Instrumentation is included in the fusion code and not reported separately. Page 8 of 15

9 ALIF and Posterolateral Fusion with Instrumentation (Classic 360 Procedure) Anterior column fusion, anterior approach, lumbar anterior interbody fusion Posterior column fusion, posterior approach, lumbar posterolateral fusion Fusion or refusion of 2-3 vertebrae (or) Fusion or refusion of 4-8 vertebrae (or) Fusion or refusion of 9 or more vertebrae Discectomy Insertion of interbody spinal fusion device Excision of bone for graft, other harvested from the iliac crest or locally Intra-operative monitoring Note: Instrumentation is included in the fusion code and not reported separately. If structural allograft is used, do not report code Allograft is included in the fusion code and not separately reported. PLIF/TLIF and Posterolateral Fusion with Posterior Instrumentation (Single Incision 360 ) Anterior column fusion, posterior approach, lumbar posterior interbody fusion Posterior column fusion, posterior approach, lumbar posterolateral fusion Fusion or refusion of 2-3 vertebrae (or) Fusion or refusion of 4-8 vertebrae (or) Fusion or refusion of 9 or more vertebrae Discectomy Insertion of interbody spinal fusion device Excision of bone for graft, other harvested from the iliac crest or locally Intra-operative monitoring Note: Instrumentation is included in the fusion code and not reported separately. If structural allograft is used, do not report code Allograft is included in the fusion code and not separately reported. Direct Lateral Interbody Fusion (DLIF) Anterior column fusion, anterior approach, lumbar anterior interbody fusion Fusion or refusion of 2-3 vertebrae (or) Fusion or refusion of 4-8 vertebrae (or) Fusion or refusion of 9 or more vertebrae Discectomy Insertion of interbody spinal fusion device Excision of bone for graft, other harvested from the iliac crest or locally Intra-operative monitoring Note: If structural allograft is used, do not report code Allograft is included in the fusion code and not separately reported. Page 9 of 15

10 Laminectomy Other exploration and decompression of spinal canal Percutaneous Vertebroplasty Percutaneous verebroplasty Percutaneous Vertebral Augmentation Percutaneous vertebral augmentation Discectomy Discectomy The information in this document was obtained from third party sources and is subject to change without notice, including as a result in changes in reimbursement laws, regulations, rules and policies. All content in this document is informational only, general in nature and does not cover all situations or all payers rules or policies. The service and the product must be reasonable and necessary for the care of the patient to support reimbursement. Providers should report the procedure and related codes that most accurately describe the patients medical condition, procedures performed and the products used. This document represents no promise or guarantee by Zimmer regarding coverage or payment for products or procedures by Medicare or other payers. Providers should check Medicare bulletins, manuals, program memoranda, and Medicare guidelines to ensure compliance with Medicare requirements. Inquiries can be directed to the hospital s Medicare Part A fiscal intermediary, the physician s Medicare Part B carrier, or to appropriate payers. Zimmer specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information in this document. For further assistance with coding questions, contact the Zimmer Reimbursement Hotline at Page 10 of 15

11 2012 SPINAL DRGS WITH SPECIFIC DETAIL MS-DRG 453 Combined Anterior/Posterior Spinal Fusion with MCC MS-DRG 454 Combined Anterior/Posterior Spinal Fusion with CC MS-DRG 455 Combined Anterior/Posterior Spinal Fusion without CC/MCC Spinal Fusions One or more of the following procedures: Fusion, anterior column, other cervical, anterior technique Fusion, anterior column, dorsal/dorsolumbar, anterior technique Fusion, anterior column, lumbar/lumbosacral, anterior technique AND One or more of the following procedures: Fusion, posterior column, other cervical, posterior technique Fusion, posterior column, dorsal/dorsolumbar, posterior technique Fusion, posterior column, lumbar/lumbosacral, posterior technique Fusion, anterior column, lumbar/lumbosacral, posterior technique Spinal Refusions One or more of the following procedures: Refusion, anterior column, other cervical, anterior technique Refusion, anterior column, dorsal/dorsolumbar, anterior technique Refusion, anterior column, lumbar/lumbosacral, anterior technique AND One or more of the following procedures: Refusion, posterior column, other cervical, posterior technique Refusion, posterior column, dorsal/dorsolumbar, posterior technique Refusion, posterior column, lumbar/lumbosacral, posterior technique Refusion, anterior column, lumbar/lumbosacral, posterior technique Page 11 of 15

12 MS-DRG 456 Spinal Fusions Except Cervical with Spinal Curvature, Malignancy or 9+ Fusions with MCC MS-DRG 457 Spinal Fusions Except Cervical with Spinal Curvature, Malignancy or 9+ Fusions with CC MS-DRG 458 Spinal Fusions Except Cervical with Spinal Curvature, Malignancy or 9+ Fusions without CC/MCC The principal diagnosis codes that will lead to this DRG assignment are the following: Tuberculosis of bones and joints, vertebral column, bacteriological or histological examination unknown (at present) Tuberculosis of bones and joints, vertebral column, tubercle bacilli not found (In sputum) by microscopy, but found by bacterial culture Tuberculosis of bones and joints, vertebral column, tubercle bacilli not found by bacteriological examination, but tuberculosis confirmed histologically Malignant neoplasm of vertebral column, excluding sacrum and coccyx Secondary malignant neoplasm of bone and bone marrow Benign neoplasm of bone and articular cartilage; vertebral column, excluding sacrum and coccyx Neoplasm of uncertain behavior of other and unspecified sites and tissues; Bone and articular cartilage Neoplasms of unspecified nature; bone, soft tissue, and skin Acute osteomyelitis of other specified sites Chronic osteomyelitis of other specified sites Unspecified osteomyelitis of other specified sites Juvenile osteochondrosis of spine Pathologic fracture of vertebrae Adolescent postural kyphosis Kyphosis (acquired) (postural) Kyphosis due to radiation Kyphosis, postlaminectomy Kyphosis (acquired), other Lordosis (acquired) (postural) Lordosis, postlaminectomy Other postsurgical lordosis Lordosis (acquired), other Scoliosis [and kyphoscoliosis], idiopathic Resolving infantile idiopathic scoliosis Progressive infantile idiopathic scoliosis Scoliosis due to radiation Thoracogenic scoliosis Other kyphoscoliosis and scoliosis Other curvatures of spine Unspecified curvature of spine Congenital scoliosis Osteogenesis imperfect The secondary diagnoses that will lead to DRG 456, 457 or 458 assignment are: Curvature of spine, unspecified Curvature of spine associated with other conditions, kyphosis Curvature of spine associated with other conditions, lordosis Curvature of spine associated with other conditions, scoliosis Page 12 of 15

13 Procedure code: Fusion or refusion of 9 or more vertebrae MS-DRG 459 Spinal Fusion Except Cervical with MCC MS-DRG 460 Spinal Fusion Except Cervical without MCC Spinal Fusions Include any of the following procedure codes: Fusion, spinal NOS Fusion, anterior column, dorsal/dorsolumbar, anterior technique Fusion, posterior column, dorsal/dorsolumbar, posterior technique Fusion, anterior column, lumbar/lumbosacral, anterior technique Fusion, posterior column, lumbar/lumbosacral, posterior technique Fusion, anterior column, lumbar/lumbosacral, posterior technique Spinal Refusions Include any of the following procedure codes: Refusion, spinal NOS Refusion, anterior column, dorsal/dorsolumbar, anterior technique Refusion, posterior column, dorsal/dorsolumbar, posterior technique Refusion, anterior column, lumbar/lumbosacral, anterior technique Refusion, posterior column, lumbar/lumbosacral, posterior technique Refusion, anterior column, lumbar/lumbosacral, posterior technique Refusion, spinal NEC MS-DRG 471 Cervical Spinal Fusion with MCC MS-DRG 472 Cervical Spinal Fusion with CC MS-DRG 473 Cervical Spinal Fusion without CC/MCC Spinal Fusions Include any of the following procedure codes: Fusion, atlas-axis Fusion, anterior column, other cervical, anterior technique Fusion, posterior column, other cervical, posterior technique Spinal Refusions Include any of the following procedure codes: Refusion, atlas-axis Refusion, anterior column, other cervical, anterior technique Refusion, posterior column, other cervical, posterior technique MS-DRG 477 Biopsies of Musculoskeletal and Connective Tissue with MCC MS-DRG 478 Biopsies of Musculoskeletal and Connective Tissue with CC MS-DRG 479 Biopsies of Musculoskeletal and Connective Tissue without CC/MCC (If a biopsy is performed at the same operative session as a vertebroplasty or percutaneous vertebral augmentation, the encounter is grouped to DRG 477, 478 or 479) Other repair or plastic operations on bone Percutaneous vertebroplasty Percutaneous vertebral augmentation Page 13 of 15

14 MS-DRG 490 Back and Neck Procedures except Spinal Fusion with CC/MCC or disc device/neurostim Include any of the following procedure codes and procedure codes listed for MS-DRG 491: Insertion of other spinal devices Insertion of total spinal disc prosthesis, cervical Insertion of total spinal disc prosthesis, lumbosacral Insertion or replacement of interspinous process device(s) Insertion or replacement of pedicle-based dynamic stabilization device(s) Insertion or replacement of facet replacement device(s) MS-DRG 491 Back and Neck Procedures except Spinal Fusion without CC/MCC Include any of the following procedure codes: Reopening, laminectomy site Exploration and decompression, other spinal canal 03.1 Division, intraspinal nerve root Biopsy, spinal cord or spinal meninges Procedure, diagnostic other spinal cord and spinal cord structures 03.4 Excision or destruction, lesion, spinal cord or spinal meninges Repair, vertebral fracture Repair and plastic operation, other spinal cord structures 03.6 Lysis, adhesions, spinal cord and nerve root Insertion or replacement, spinal neurostimulator Removal, spinal neurostimulator Revision, spinal thecal shunt Removal, spinal thecal shunt Operation, other, spinal cord and spinal canal structures Excision or destruction, intervertebral disc, unspecified Excision, intervertebral disc Repair of the annulus fibrosus with graft or prosthesis Other and unspecified repair of the annulus fibrosus Destruction, other intervertebral disc Insertion of spinal disc prosthesis, not otherwise specified Insertion of partial spinal disc prosthesis, cervical Insertion of spinal disc prosthesis, thoracic Insertion of partial spinal disc prosthesis, lumbosacral Revision or replacement of artificial spinal disc prosthesis, cervical Revision or replacement of artificial spinal disc prosthesis, thoracic Revision or replacement of artificial spinal disc prosthesis, lumbosacral Revision or replacement of artificial spinal disc prosthesis, not otherwise specified MS-DRG 515 Other Musculoskeletal System and Connective Tissue O.R. Procedure with MCC MS-DRG 516 Other Musculoskeletal System and Connective Tissue O.R. Procedure with CC MS-DRG 517 Other Musculoskeletal System and Connective Tissue O.R. Procedure without CC/MCC Percutaneous vertebroplasty Percutaneous vertebral augmentation Revision of interspinous process device(s) Revision of pedicle-based dynamic stabilization device(s) Revision of facet replacement device(s) Page 14 of 15

15 MS-DRG 28 Spinal Procedures with MCC MS-DRG 29 Spinal Procedures with CC or spinal neurostimulators MS-DRG 30 Spinal Procedures without CC/MCC 03.0X Exploration and decompression, spinal canal structures 03.1 Division, intraspinal nerve root 03.2 Chordotomy Biopsy, spinal cord or spinal meninges Procedure, diagnostic, other, spinal cord and spinal canal structures 03.4 Excision or destruction, lesion, spinal cord or spinal meninges 03.5 Repair, spinal cord structures 03.6 Lysis, adhesions, spinal cord and nerve roots Operation, other spinal cord and spinal canal structures Excision or destruction, intervertebral disc, unspecified Excision, intervertebral disc Repair of the annulus fibrosus with graft or prosthesis Other and unspecified repair of the annulus fibrosus Destruction, other, intervertebral disc 81.0x Fusion, spinal 81.3x Revision, spinal Insertion of other spinal devices Insertion of spinal disc prosthesis, not otherwise specified Insertion of partial spinal disc prosthesis, cervical Insertion of total spinal disc prosthesis, cervical Insertion of spinal disc prosthesis, thoracic Insertion of partial spinal disc prosthesis, lumbosacral Insertion of total spinal disc prosthesis, lumbosacral Revision or replacement of artificial spinal disc prosthesis, cervical Revision or replacement of artificial spinal disc prosthesis, thoracic Revision or replacement of artificial spinal disc prosthesis, lumbosacral Revision or replacement of artificial spinal disc prosthesis, not otherwise specified Implantation of interspinous process decompression device(s) Insertion or replacement of pedicle-based dynamic stabilization device(s) CC Complications and/or comorbidities, MCC Major Complications and/or comorbidities The information in this document was obtained from third party sources and is subject to change without notice, including as a result in changes in reimbursement laws, regulations, rules and policies. All content in this document is informational only, general in nature and does not cover all situations or all payers rules or policies. The service and the product must be reasonable and necessary for the care of the patient to support reimbursement. Providers should report the procedure and related codes that most accurately describe the patients medical condition, procedures performed and the products used. This document represents no promise or guarantee by Zimmer regarding coverage or payment for products or procedures by Medicare or other payers. Providers should check Medicare bulletins, manuals, program memoranda, and Medicare guidelines to ensure compliance with Medicare requirements. Inquiries can be directed to the hospital s Medicare Part A fiscal intermediary, the physician s Medicare Part B carrier, or to appropriate payers. Zimmer specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information in this document. For further assistance with coding questions, contact the Zimmer Reimbursement Hotline at Page 15 of 15

Effective October 1, 2014 Spinal Surgery Medicare Severity- Diagnosis Related Groups (MS-DRGs)

Effective October 1, 2014 Spinal Surgery Medicare Severity- Diagnosis Related Groups (MS-DRGs) 2014 HOSPITAL CODING MANUAL CHAPTER 4: 2014 SPINAL SURGERY (MS-DRGS) 1 Effective October 1, 2014 Spinal Surgery Medicare Severity- Diagnosis Related Groups (MS-DRGs) DRGs are the prospective payment system

More information

Spinal Surgery Functional Status and Quality of Life Outcome Specifications 2015 (01/01/2013 to 12/31/2013 Dates of Procedure) September 2014

Spinal Surgery Functional Status and Quality of Life Outcome Specifications 2015 (01/01/2013 to 12/31/2013 Dates of Procedure) September 2014 Description Methodology For patients ages 18 years and older who undergo a lumbar discectomy/laminotomy or lumbar spinal fusion procedure during the measurement year, the following measures will be calculated:

More information

The Four Elements. CPT 2012 Professional Edition

The Four Elements. CPT 2012 Professional Edition The Four Elements Presented by Barbara Cataletto, MBA, CPC Disclaimer The following presentations are not to be considered a replacement for the Current Procedural Terminology (CPT) book or the International

More information

Presented by Zoran Maric, M.D. Orthopaedic Spine Surgeon May 22, 2010

Presented by Zoran Maric, M.D. Orthopaedic Spine Surgeon May 22, 2010 Presented by Zoran Maric, M.D. Orthopaedic Spine Surgeon May 22, 2010 1 cervical area thoracic area lumbar area sacrum coccyx Mayfield Clinic 2 3 4 5 Zoran Maric, MD Spine Surgery Procedures How to Document

More information

CPT Changes in Spine 2012

CPT Changes in Spine 2012 CPT Changes in Spine 2012 Are you prepared? Presented by Barbara Cataletto, MBA, CPC Disclaimer The following presentations are not to be considered a replacement for the Current Procedural Terminology

More information

Spinal Interventional Pain Management and Lumbar Spine Surgery

Spinal Interventional Pain Management and Lumbar Spine Surgery Spinal Interventional Pain Management and Lumbar Spine Surgery Policy Number: Original Effective Date: MM.06.024 01/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 07/01/2014

More information

MDC 1 DISEASES AND DISORDERS OF THE NERVOUS SYSTEM Implantation of chemotherapeutic agent Intracranial stents

MDC 1 DISEASES AND DISORDERS OF THE NERVOUS SYSTEM Implantation of chemotherapeutic agent Intracranial stents To assist the readers in identifying all changes that were made to the MS-DRGs as a result of comments, we developed the attached table that summaries those changes. MS-DRG Summary Table PRE-MDC Intestinal

More information

REIMBURSEMENT GUIDE. CD Horizon Spire. Spinal System. and. CD Horizon Spire Z. Spinal System

REIMBURSEMENT GUIDE. CD Horizon Spire. Spinal System. and. CD Horizon Spire Z. Spinal System REIMBURSEMENT GUIDE CD Horizon Spire Spinal System and CD Horizon Spire Z Spinal System REIMBURSEMENT GUIDE The CD Horizon Spire Plate is a posterior, single-level, non-pedicle supplemental fixation device

More information

Coding for Spinal Procedures

Coding for Spinal Procedures Coding for Spinal Procedures Audio Seminar/Webinar October 22, 2009 Practical Tools for Seminar Learning Copyright 2009 American Health Information Management Association. All rights reserved. Disclaimer

More information

2015 Spinal Procedure Coding Reference

2015 Spinal Procedure Coding Reference 12 2014 HOSPITAL CODING MANUAL CHAPTER 5: 2014 SPINAL PROCEDURE REFERENCE 2015 Spinal Procedure Coding Reference COMPUTER ASSISTED SURGERY (CAS) 00.31 CAS with CT/CTA 00.32 CAS with MR/MRA 00.33 CAS with

More information

KYPHON. Reimbursement Guide. Physician Reimbursement. Balloon Kyphoplasty Procedure. ICD-9-CM Diagnosis Codes. CPT Codes and Payment

KYPHON. Reimbursement Guide. Physician Reimbursement. Balloon Kyphoplasty Procedure. ICD-9-CM Diagnosis Codes. CPT Codes and Payment KYPHON Balloon Kyphoplasty Procedure Reimbursement Guide ICD-9-CM Diagnosis Codes Providers should report the ICD-9-CM diagnosis code that most accurately describes the patient s condition. Please refer

More information

Spine Surgery Coding

Spine Surgery Coding Spine Surgery Coding Lynn M. Anderanin, CPC,CPC-I,COSC 1 Spine Anatomy 7 cervical (neck) vertebrae, 12 thoracic (chest) vertebrae, 5 lumbar (back) vertebrae, and 5 fused vertebra that make up the sacrum

More information

Spine Surgery Coding: Don t Break Your Neck Trying to Figure It Out

Spine Surgery Coding: Don t Break Your Neck Trying to Figure It Out Spine Surgery Coding: Don t Break Your Neck Trying to Figure It Out Presented to: AAPC Annual Meeting Orlando, Florida April 15, 2013 Presented by: Kim Pollock, RN, MBA, CPC www.karenzupko.com Kim Pollock,

More information

ICD 10 CM IMPLEMENTATION DATE OCT 1, 2015

ICD 10 CM IMPLEMENTATION DATE OCT 1, 2015 Presented by: Teri Romano, RN, MBA, CPC, CMDP ICD 10 CM IMPLEMENTATION DATE OCT 1, 2015 Source: http://journal.ahima.org/2015/02/04/us house committee to hold hearing on icd 10 implementation/ 2 2015 Web_Non

More information

Spinal Surgery Clinical Coverage Policy No: 1A-30 Revised Date: DRAFT Table of Contents

Spinal Surgery Clinical Coverage Policy No: 1A-30 Revised Date: DRAFT Table of Contents Clinical Coverage Policy No: 1A-30 Table of Contents 1.0 Description of the Procedure, Product, or Service... 1 1.1 Definitions... 1 2.0 Eligible Recipients... 2 2.1 General Provisions... 2 2.2 EPSDT Special

More information

Getting to the Backbone of Spinal Coding in ICD-10-PCS

Getting to the Backbone of Spinal Coding in ICD-10-PCS Getting to the Backbone of Spinal Coding in ICD-10-PCS Sponsored by 1915 N. Fine Ave #104 Fresno CA 93720-1565 Phone: (559) 251-5038 Fax: (559) 251-5836 www.californiahia.org Program Handouts Tuesday,

More information

How to Overcome the 5 Biggest Reimbursement Challenges in Joint & Spine Coding

How to Overcome the 5 Biggest Reimbursement Challenges in Joint & Spine Coding How to Overcome the 5 Biggest Reimbursement Challenges in Joint & Spine Coding Presented by: Carolyn Neumann, CPC Senior Manager Coding and Coverage Access The opinions and codes denoted within are suggestions

More information

Procedure. 2 29827 $ 3,560 $ 1,476 Arthroscopy, shoulder, surgical; with rotator cuff repair 5.5% 241.1%

Procedure. 2 29827 $ 3,560 $ 1,476 Arthroscopy, shoulder, surgical; with rotator cuff repair 5.5% 241.1% Exhibit 1 Top 50% of Payments for Surgical s (Physician costs) On average, Workers' payments for Surgical s in are 256% the average allowed claim costs for Healthcare in. $6,000 $5,000 $4,000 Allowed Claim

More information

Patient Information. Anterior Cervical Discectomy and Fusion Surgery (ACDF).

Patient Information. Anterior Cervical Discectomy and Fusion Surgery (ACDF). Patient Information. Anterior Cervical Discectomy and Fusion Surgery (ACDF). Understanding your spine Disc Between each pair of vertebrae there is a disc that acts as a cushion to protect the vertebra,

More information

SPINAL SURGICAL PROCEDURES

SPINAL SURGICAL PROCEDURES Spinal Surgical ProceduresApril 1, 2015 PREAMBLE [Commentary: The structure of this section uses N prefix codes to describe the basic elements of spine surgery: decompression and arthrodesis (fusion),

More information

Report 1 ICD-9-CM PROCEDURE CODES

Report 1 ICD-9-CM PROCEDURE CODES Report 1 ICD-9-CM PROCEDURE CODES ICD-9-CM procedure codes are based on the official version of the World Health Organization s Ninth Revision, International Classification of Diseases (ICD-9). Volume

More information

Patient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF).

Patient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF). Patient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF). Understanding your spine Disc Between each pair of vertebrae there is a disc that acts as a cushion to protect the vertebra, allows

More information

SURGICAL TREATMENT FOR SPINE PAIN

SURGICAL TREATMENT FOR SPINE PAIN Lots of MEDICAL POLICY SURGICAL TREATMENT FOR SPINE PAIN Policy Number: 2015T0547J Effective Date: April 1, 2015 Table of Contents BENEFIT CONSIDERATIONS COVERAGE RATIONALE APPLICABLE CODES.. DESCRIPTION

More information

Reimbursement Overview Supporting Adjunctive Use of the coflex-f Implant During Lumbar Fusion Procedures

Reimbursement Overview Supporting Adjunctive Use of the coflex-f Implant During Lumbar Fusion Procedures Interlaminar Technology Reimbursement Overview Supporting Adjunctive Use of the coflex-f Implant During Lumbar Fusion Procedures Coding Recommendations Overview Implant Description & Device Type Differentiation

More information

Crosswalk of Common Spine ICD-9-CM Codes to ICD-10 Codes

Crosswalk of Common Spine ICD-9-CM Codes to ICD-10 Codes Crosswalk of Common Spine ICD-9-CM Codes to ICD-10 Codes As of October 1, 2015, all health care entities covered by the Health Insurance Portability and Accountability Act (HIPAA) will be required to use

More information

Minimally Invasive Spine Surgery What is it and how will it benefit patients?

Minimally Invasive Spine Surgery What is it and how will it benefit patients? Minimally Invasive Spine Surgery What is it and how will it benefit patients? Dr Raoul Pope MBChB, FRACS, Neurosurgeon and Minimally Invasive Spine Surgeon Concord Hospital and Mater Private Hospital Sydney

More information

22830-62,-59,-22,-51; 22855,-80,-22,-59,-51; 63090-62,-22, 63091-62,-22; and 63047-62,-22

22830-62,-59,-22,-51; 22855,-80,-22,-59,-51; 63090-62,-22, 63091-62,-22; and 63047-62,-22 MAXIMUS FEDERAL SERVICES, INC. Independent Bill Review P.O. Box 138006 Sacramento, CA 95813-8006 Fax: (916) 605-4280 Independent Bill Review Final Determination Reversed 9/18/2014 IBR Case Number: CB14-0000102

More information

Alaska Workers Compensation Fee Schedule Comparative Survey

Alaska Workers Compensation Fee Schedule Comparative Survey Alaska Workers Compensation Fee Comparative Survey As part of the Division s analysis of workers compensation medical costs in Alaska, we asked the National Council on Compensation Insurance (NCCI) to

More information

Patient Guide to Stenosis

Patient Guide to Stenosis Patient Guide to Stenosis For Your Spinal Education Compliments of Your Spine Health Professional Dr. Schlesinger & Dr. Thomas Arkansas Neurosurgery Clinic 501-661-0077 www.arneuro.com Stenosis Description:

More information

LUMBAR FUSION. Effective Date: June 27, 2016 Review Dates: 4/11, 4/12, 4/13, 8/13, 5/14, 8/14, 8/15, 5/16

LUMBAR FUSION. Effective Date: June 27, 2016 Review Dates: 4/11, 4/12, 4/13, 8/13, 5/14, 8/14, 8/15, 5/16 LUMBAR FUSION MEDICAL POLICY Effective Date: June 27, 2016 Review Dates: 4/11, 4/12, 4/13, 8/13, 5/14, 8/14, 8/15, 5/16 Date Of Origin: April 13, 2011 Status: Current Summary of Changes Clarifications:

More information

ICD-10-PCS Documentation and Coding for Spinal Procedures October 22, 2015

ICD-10-PCS Documentation and Coding for Spinal Procedures October 22, 2015 Questions and Answers 1. We have a question regarding a spinal surgical procedure. The diagnosis was bilateral lateral recess stenosis and central stenosis from L2-L5. The procedure was an open lumbar

More information

MEDICAL POLICY No. 91591-R2 LUMBAR LAMINECTOMY Including Discectomy or Microdiscectomy, Foraminotomy, Laminotomy

MEDICAL POLICY No. 91591-R2 LUMBAR LAMINECTOMY Including Discectomy or Microdiscectomy, Foraminotomy, Laminotomy LUMBAR LAMINECTOMY Effective Date: June 4, 2015 Review Dates: 4/11, 4/12, 4/13, 5/14, 5/15 Date Of Origin: April 13, 2011 Status: Current Note: The prior authorization requirement was removed effective

More information

Anatomy and Terminology of the Spine. Bones of the Spine (Vertebrae)

Anatomy and Terminology of the Spine. Bones of the Spine (Vertebrae) Anatomy and Terminology of the Spine The spine, also called the spinal column, vertebral column or backbone, consists of bones, intervertebral discs, ligaments, and joints. In addition, the spine serves

More information

Advances In Spine Care. James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery

Advances In Spine Care. James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery Advances In Spine Care James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery Introduction The Spine - A common source of problems Back pain is the #2 presenting

More information

CPT 76977, 77078, 77079, 77080, 77081, 77083, or HCPCS G0130:

CPT 76977, 77078, 77079, 77080, 77081, 77083, or HCPCS G0130: Bone Mass Measurements Coverage Information Noridian Administrative Services (NAS), LLC, is providing coverage information regarding Bone Mass Measurements (BMM) in response to multiple provider inquiries.

More information

Surgical Procedures of the Spine

Surgical Procedures of the Spine Surgical Procedures of the Spine Jaideep Chunduri, M.D. Orthopaedic Spine Surgeon Beacon Orthopaedics and Sports Medicine Beacon Spine Center Objectives Discuss the 4 most common procedures performed in

More information

Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete 76642 limited

Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete 76642 limited Radiology CPT Coding Updates for 2015 Note: This article contains coding information from the 2015 Physician's Current Procedural Terminology (CPT ) Manual. CPT is a registered trademark of the American

More information

Rotator Cuff Repair Surgical Procedures

Rotator Cuff Repair Surgical Procedures Rotator Cuff Repair Surgical Procedures 2011 Reimbursement and Coding Reference Guide for Physicians and Hospitals This coding reference guide is intended to illustrate the common CPT * codes, ICD-9 CM

More information

SPINE ANATOMY AND PROCEDURES. Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132

SPINE ANATOMY AND PROCEDURES. Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132 SPINE ANATOMY AND PROCEDURES Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132 SPINE ANATOMY The spine consists of 33 bones called vertebrae. The top 7 are cervical, or neck

More information

APSS YANGON OPERATIVE SPINE COURSE. Local Organizing Chairman: Prof Myint Thaung. Venue: Yangon Orthopaedic Hospital

APSS YANGON OPERATIVE SPINE COURSE. Local Organizing Chairman: Prof Myint Thaung. Venue: Yangon Orthopaedic Hospital 5 th - 8 th Feb 2015 Pls insert Hospital Logo here Local Organizing Chairman: Prof Myint Thaung Venue: Yangon Orthopaedic Hospital Invited International and Local Faculties Arvind Jayaswal (India) Chung-Chek

More information

Sciatica: Low back and Leg Pain Diagnosis and Treatment Options. Presented by Devesh Ramnath, MD Orthopaedic Associates Of Dallas Baylor Spine Center

Sciatica: Low back and Leg Pain Diagnosis and Treatment Options. Presented by Devesh Ramnath, MD Orthopaedic Associates Of Dallas Baylor Spine Center Sciatica: Low back and Leg Pain Diagnosis and Treatment Options Presented by Devesh Ramnath, MD Orthopaedic Associates Of Dallas Baylor Spine Center Sciatica Compression of the spinal nerves in the back

More information

Utilization and Cost of Surgery for Lumbar Spinal Stenosis in a Commercially Insured Population

Utilization and Cost of Surgery for Lumbar Spinal Stenosis in a Commercially Insured Population Utilization and Cost of Surgery for Lumbar Spinal Stenosis in a Commercially Insured Population Prepared by Milliman, Inc. Kathryn Fitch, RN, MEd Principal and Healthcare Management Consultant Helen Blumen,

More information

POSTERIOR LUMBAR INTERBODY FUSION. PLIF with Instrumentation. Basic Anatomical Landmarks: Posterior View Lumbar Spine

POSTERIOR LUMBAR INTERBODY FUSION. PLIF with Instrumentation. Basic Anatomical Landmarks: Posterior View Lumbar Spine POSTERIOR LUMBAR INTERBODY FUSION PLIF with Instrumentation Posterior In human anatomy, referring to the back surface of the body or the position of one structure relative to another Lumbar Relating to

More information

CODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT. Effective January 1, 2011 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE

CODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT. Effective January 1, 2011 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE CODING SHEETS CHRONIC INTRACTABLE PAIN MANAGEMENT Effective January 1, 2011 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE Phone: 800-609-1108 Email: codmanpump@aol.com Fax: 303-703-1572

More information

Post operative Spinal Imaging- A multimodality approach

Post operative Spinal Imaging- A multimodality approach Post operative Spinal Imaging- A multimodality approach UKRC June 2014 Dr Sajid Butt Consultant Radiology, RNOH Summary Common Spinal Surgeries Image Optimisation Spinal Instrumentation Clinical Scenarios

More information

SPINAL FUSION. North American Spine Society Public Education Series

SPINAL FUSION. North American Spine Society Public Education Series SPINAL FUSION North American Spine Society Public Education Series WHAT IS SPINAL FUSION? The spine is made up of a series of bones called vertebrae ; between each vertebra are strong connective tissues

More information

Spinal Arthrodesis Group Exercises

Spinal Arthrodesis Group Exercises Spinal Arthrodesis Group Exercises 1. Two surgeons work together to perform an arthrodesis. Dr. Bonet, a general surgeon, makes the anterior incision to gain access to the spine for the arthrodesis procedure.

More information

Workers Compensation Insurance

Workers Compensation Insurance Workers Compensation Insurance New Hampshire Insurance Department Detailed Medical Cost Comparison The following exhibits compare the cost of Workers Compensation Medical services in New Hampshire to our

More information

Aetna Injection Policy For Back Pain

Aetna Injection Policy For Back Pain Aetna Injection Policy For Back Pain Number: 0016 Policy Aetna considers any of the following injections or procedures medically necessary for the treatment of back pain; provided, however, that only 1

More information

MINIMAL ACCESS SPINE SURGERY

MINIMAL ACCESS SPINE SURGERY MINIMAL ACCESS SPINE SURGERY Spinal ailments are amongst the most common ailments that afflict mankind. Back pain, for example, has achieved epidemic proportions worldwide in the last two decades and is

More information

MEDICAL POLICY No. 91591-R2 LUMBAR LAMINECTOMY Including Discectomy or Microdiscectomy, Foraminotomy, Laminotomy

MEDICAL POLICY No. 91591-R2 LUMBAR LAMINECTOMY Including Discectomy or Microdiscectomy, Foraminotomy, Laminotomy LUMBAR LAMINECTOMY Effective Date: June 4, 2015 Review Dates: 4/11, 4/12, 4/13, 5/14, 5/15, 5/16 Date Of Origin: April 13, 2011 Status: Current Note: The prior authorization requirement was removed effective

More information

Spine Clinic Neurospine Specialists, Orthopaedics and Neurosurgery

Spine Clinic Neurospine Specialists, Orthopaedics and Neurosurgery Spine Clinic Neurospine Specialists, Orthopaedics and Neurosurgery REVISION SPINE SURGERY Revision surgery is a very complex field which requires experience, training and evaluation in a very individual

More information

Chapter 8. The Vertebral Column

Chapter 8. The Vertebral Column Chapter 8 The Vertebral Column The Vertebral Column (Spine) functions supports the skull and trunk allows for their movement protects the spinal cord absorbs stress of walking, running, and lifting provides

More information

Workers Compensation Medical Costs in NH Significantly Higher

Workers Compensation Medical Costs in NH Significantly Higher EMBARGOED: FOR RELEASE THURSDAY, MAY 22, 10 AM NOT FOR RELEASE UNTIL: May 22, 2014 Contact: Danielle Barrick, director of communications, (603) 271-7973, ext. 336, danielle.barrick@ins.nh.gov; Deb Stone,

More information

Options for Cervical Disc Degeneration A Guide to the Fusion Arm of the M6 -C Artificial Disc Study

Options for Cervical Disc Degeneration A Guide to the Fusion Arm of the M6 -C Artificial Disc Study Options for Cervical Disc Degeneration A Guide to the Fusion Arm of the M6 -C Artificial Disc Study Each year, hundreds of thousands of adults are diagnosed with Cervical Disc Degeneration, an upper spine

More information

Minimally Invasive Spine Surgery For Your Patients

Minimally Invasive Spine Surgery For Your Patients Minimally Invasive Spine Surgery For Your Patients Lukas P. Zebala, M.D. Assistant Professor Orthopaedic and Neurological Spine Surgery Department of Orthopaedic Surgery Washington University School of

More information

visualized. The correct level is then identified again. With the use of a microscope and

visualized. The correct level is then identified again. With the use of a microscope and SURGERY FOR SPINAL STENOSIS Laminectomy A one inch (or longer for extensive stenosis) incision is made in the middle of the back over the effected region of the spine. The muscles over the bone are moved

More information

CMS Limitations Guide Mammograms and Bone Density Radiology Services

CMS Limitations Guide Mammograms and Bone Density Radiology Services CMS Limitations Guide Mammograms and Bone Density Radiology Services Starting July 1, 2008, CMS has placed numerous medical necessity limits on tests and procedures. This reference guide provides you with

More information

Clinical Privileges Profile Orthopedic Surgery. Kettering Medical Center System

Clinical Privileges Profile Orthopedic Surgery. Kettering Medical Center System Printed Name Clinical Privileges Profile Orthopedic Surgery Kettering Medical Center Sycamore Medical Center Kettering Medical Center System Applicant: Check off the Requested box for each privilege requested.

More information

Options for Cervical Disc Degeneration A Guide to the M6-C. clinical study

Options for Cervical Disc Degeneration A Guide to the M6-C. clinical study Options for Cervical Disc Degeneration A Guide to the M6-C clinical study Each year, hundreds of thousands of adults are diagnosed with Cervical Disc Degeneration, an upper spine condition that can cause

More information

Human Anatomy & Physiology

Human Anatomy & Physiology PowerPoint Lecture Slides prepared by Barbara Heard, Atlantic Cape Community College Ninth Edition Human Anatomy & Physiology C H A P T E R 7 The Skeleton: Part B Annie Leibovitz/Contact Press Images Vertebral

More information

Patient Information. Anterior Lumbar Interbody Fusion

Patient Information. Anterior Lumbar Interbody Fusion Patient Information Anterior Lumbar Interbody Fusion Table of Contents Anatomy of the Spine 2 The Healthy Spine 3 General Treatment Options 4 General Conditions of the Lumbar Spine 5 What is Spondylolisthesis?

More information

Coding Inaccuracies That May Put an ASC or Practice at Risk With the OIG and RACs OBJECTIVES: Medicare Edits (NCCI)

Coding Inaccuracies That May Put an ASC or Practice at Risk With the OIG and RACs OBJECTIVES: Medicare Edits (NCCI) Coding Inaccuracies That May Put an ASC or Practice at Risk With the OIG and RACs Cristina Bentin, CPC-H, CCS-P, CMA President cristina@ccmpro.com 225.752.8390 OBJECTIVES: Medicare Edits- Improper Usage

More information

Neck and Back Pain in VA Incidence and Prevalence in VA Users

Neck and Back Pain in VA Incidence and Prevalence in VA Users Neck and Back Pain in VA Incidence and Prevalence in VA Users Spotlight on Pain Management: Patsi Sinnott, PT, PhD, MPH Sharon Dally, MS, Tigran Avoundjian, MPH, Jody Trafton, PhD, Todd Wagner, PhD Dec.

More information

EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN

EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN MEDICAL POLICY EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN Policy Number: 2015T0004W Effective Date: December 1, 2015 Table of Contents BENEFIT CONSIDERATIONS COVERAGE RATIONALE APPLICABLE CODES..

More information

Clarification of Medicare Benefits Schedule rules for the Transport Accident Commission and WorkSafe Victoria

Clarification of Medicare Benefits Schedule rules for the Transport Accident Commission and WorkSafe Victoria Clarification of Medicare Benefits Schedule rules for the Transport Accident Commission and WorkSafe Victoria MAY 2013 When paying the reasonable costs of medical services, the TAC and WorkSafe pay in

More information

LOW BACK PAIN; MECHANICAL

LOW BACK PAIN; MECHANICAL 1 ORTHO 16 LOW BACK PAIN; MECHANICAL Background This case definition was developed by the Armed Forces Health Surveillance Center (AFHSC) for the purpose of epidemiological surveillance of a condition

More information

Each year, hundreds of thousands of adults are diagnosed with Cervical Disc Degeneration, The Cervical Spine. What is the Cervical Spine?

Each year, hundreds of thousands of adults are diagnosed with Cervical Disc Degeneration, The Cervical Spine. What is the Cervical Spine? Each year, hundreds of thousands of adults are diagnosed with Cervical Disc Degeneration, an upper spine condition that can cause pain and numbness in the neck, shoulders, arms, and even hands. This patient

More information

UNIT 10 Musculoskeletal Systems Pathological Conditions

UNIT 10 Musculoskeletal Systems Pathological Conditions UNIT 10 Musculoskeletal Systems Pathological Conditions MUSCULAR DYSTROPHY Group of hereditary diseases characterized by gradual atrophy and weakness of muscle tissue. There is no cure for muscular dystrophy.

More information

https://www.laserspineinstitute.com/back_problems/foraminal_stenosis/e...

https://www.laserspineinstitute.com/back_problems/foraminal_stenosis/e... Questions? Call toll free 1-866-249-1627 Contact us today. We're here for you seven days a week. MRI Review Consultation Live help Call 1-866-249-1627 Chat Live Home Laser Spine Institute Laser Spine Institute's

More information

CODING SHEETS CHRONIC INTRACTABLE SPASTICITY. Effective January 1, 2009 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE

CODING SHEETS CHRONIC INTRACTABLE SPASTICITY. Effective January 1, 2009 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE CODING SHEETS CHRONIC INTRACTABLE SPASTICITY Effective January 1, 2009 CODMAN 3000 NEUROMODULATION AND ONCOLOGY REIMBURSEMENT HOTLINE Phone: 800-609-1108 Email: codmanpump@aol.com Fax: 303-703-1572 CODMAN

More information

EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN

EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN CLINICAL POLICY EPIDURAL STEROID AND FACET INJECTIONS FOR SPINAL PAIN Policy Number: PAIN 019.16 T2 Effective Date: December 1, 2015 Table of Contents CONDITIONS OF COVERAGE... BENEFIT CONSIDERATIONS..

More information

ISPI Newsletter Archive Lumbar Spine Surgery

ISPI Newsletter Archive Lumbar Spine Surgery ISPI Newsletter Archive Lumbar Spine Surgery January 2005 Effects of Charite Artificial Disc on the Implanted and Adjacent Spinal Segments Mechanics Using a Hybrid Testing Protocol Spine. 30(24):2755-2764,

More information

Reimbursement Guide: Hernia and Abdominal Wall Repair

Reimbursement Guide: Hernia and Abdominal Wall Repair For more information Ask your Covidien sales representative how procedural solutions for hernia repair can enhance your specialty. Call 1-800-722-8772 today to order product brochures, DVDs or detailed

More information

Objectives. Axial Skeleton 2 APPENDICULAR SKELETON AXIAL SKELETON. Functions. Spine Supports Body

Objectives. Axial Skeleton 2 APPENDICULAR SKELETON AXIAL SKELETON. Functions. Spine Supports Body Objectives Axial Skeleton 2 Vertebral Column and Thorax 1. Identify the subdivisions of the skeleton as axial or appendicular 2. Explain how the spine supports the body. 3. Explain the changes on vertebrae

More information

White Paper: Reducing Utilization Concerns Regarding Spinal Fusion and Artificial Disc Implants

White Paper: Reducing Utilization Concerns Regarding Spinal Fusion and Artificial Disc Implants White Paper: Reducing Utilization Concerns Regarding Spinal Fusion and Artificial Disc Implants For Health Plans, Medical Management Organizations and TPAs Executive Summary Back pain is one of the most

More information

Direct Lateral Interbody Fusion A Minimally Invasive Approach to Spinal Stabilization

Direct Lateral Interbody Fusion A Minimally Invasive Approach to Spinal Stabilization APPROVED IRN10389-1.1-04 Direct Lateral Interbody Fusion A Minimally Invasive Approach to Spinal Stabilization Because it involves accessing the spine through the patient s side, the Direct Lateral approach

More information

Information for the Patient About Surgical

Information for the Patient About Surgical Information for the Patient About Surgical Decompression and Stabilization of the Spine Aging and the Spine Daily wear and tear, along with disc degeneration due to aging and injury, are common causes

More information

A Patient s Guide to the Disorders of the Cervical and Upper Thoracic Spine

A Patient s Guide to the Disorders of the Cervical and Upper Thoracic Spine A Patient s Guide to the Disorders of the Cervical and Upper Thoracic Spine General Anatomy of the Spine The spine can be divided into four regions based on vertebral shape and sagittal plane curve.» CERVICAL:

More information

Thoracic Spine Anatomy

Thoracic Spine Anatomy A Patient s Guide to Thoracic Spine Anatomy 228 West Main, Suite C Missoula, MT 59802 Phone: info@spineuniversity.com DISCLAIMER: The information in this booklet is compiled from a variety of sources.

More information

ANTERIOR LUMBAR INTERBODY FUSION (ALIF) Basic Anatomical Landmarks: Anterior Lumbar Spine

ANTERIOR LUMBAR INTERBODY FUSION (ALIF) Basic Anatomical Landmarks: Anterior Lumbar Spine (ALIF) Anterior In human anatomy, referring to the front surface of the body or the position of one structure relative to another Lumbar Relating to the loins or the section of the back and sides between

More information

Treatment Concepts for Degenerative Spinal Diseases PARADIGM SPINE

Treatment Concepts for Degenerative Spinal Diseases PARADIGM SPINE Treatment Concepts for Degenerative Spinal Diseases PARADIGM SPINE What You Need To Know About Your Spine It is important to understand the role of the spine, the changes that occur in your spine as your

More information

Spinal Surgery 2. Teaching Aims. Common Spinal Pathologies. Disc Degeneration. Disc Degeneration. Causes of LBP 8/2/13. Common Spinal Conditions

Spinal Surgery 2. Teaching Aims. Common Spinal Pathologies. Disc Degeneration. Disc Degeneration. Causes of LBP 8/2/13. Common Spinal Conditions Teaching Aims Spinal Surgery 2 Mr Mushtaque A. Ishaque BSc(Hons) BChir(Cantab) DM FRCS FRCS(Ed) FRCS(Orth) Hunterian Professor at The Royal College of Surgeons of England Consultant Orthopaedic Spinal

More information

Medical Policy An independent licensee of the Blue Cross Blue Shield Association

Medical Policy An independent licensee of the Blue Cross Blue Shield Association Interspinous Fixation (Fusion) Devices Page 1 of 6 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: See Also: Interspinous Fixation (Fusion) Devices Lumbar Spine

More information

Minimally Invasive Spine Surgery

Minimally Invasive Spine Surgery Chapter 1 Minimally Invasive Spine Surgery 1 H.M. Mayer Primum non nocere First do no harm In the long history of surgery it always has been a basic principle to restrict the iatrogenic trauma done to

More information

DUKE ORTHOPAEDIC SURGERY GOALS AND OBJECTIVES SPINE SERVICE

DUKE ORTHOPAEDIC SURGERY GOALS AND OBJECTIVES SPINE SERVICE GOALS AND OBJECTIVES PATIENT CARE Able to perform a complete musculoskeletal and neurologic examination on the patient including cervical spine, thoracic spine, and lumbar spine. The neurologic examination

More information

Policy #: 111 Latest Review Date: January 2010

Policy #: 111 Latest Review Date: January 2010 Name of Policy: Co-surgeons and Team Surgeons Policy #: 111 Latest Review Date: January 2010 Category: Administrative Policy Grade: N/A Background: As a general rule, benefits are payable under Blue Cross

More information

1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or

1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or 1 REVISOR 5223.0070 5223.0070 MUSCULOSKELETAL SCHEDULE; BACK. Subpart 1. Lumbar spine. The spine rating is inclusive of leg symptoms except for gross motor weakness, bladder or bowel dysfunction, or sexual

More information

A Patient s Guide to Artificial Cervical Disc Replacement

A Patient s Guide to Artificial Cervical Disc Replacement A Patient s Guide to Artificial Cervical Disc Replacement Each year, hundreds of thousands of adults are diagnosed with Cervical Disc Degeneration, an upper spine condition that can cause pain and numbness

More information

ENTITLEMENT ELIGIBILITY GUIDELINES SPONDYLOLISTHESIS AND SPONDYLOLYSIS

ENTITLEMENT ELIGIBILITY GUIDELINES SPONDYLOLISTHESIS AND SPONDYLOLYSIS ENTITLEMENT ELIGIBILITY GUIDELINES SPONDYLOLISTHESIS AND SPONDYLOLYSIS MPC 01414 ICD-9 756.12; 738.41; 756.11 DEFINITION Spondylolisthesis is generally defined as an anterior or posterior slipping or displacement

More information

Codes for Qualis Health Rev. updated 12/26/2012. 22532 Arthrodesis lateral extracavitary thoracic. 22533 Arthrodesis lateral extracavitary lumbar

Codes for Qualis Health Rev. updated 12/26/2012. 22532 Arthrodesis lateral extracavitary thoracic. 22533 Arthrodesis lateral extracavitary lumbar 22532 Arthrodesis lateral extracavitary thoracic 22533 Arthrodesis lateral extracavitary lumbar 22534 Arthrodesis lat extracavitary ea addl thrc/lmbr 22548 Neck spine fusion 22551 Neck spine fuse&remov

More information

Lumbar Spine Anatomy. eorthopod.com 228 West Main St., Suite D Missoula, MT 59802-4345 Phone: 406-721-3072 Fax: 406-721-2619 info@eorthopod.

Lumbar Spine Anatomy. eorthopod.com 228 West Main St., Suite D Missoula, MT 59802-4345 Phone: 406-721-3072 Fax: 406-721-2619 info@eorthopod. A Patient s Guide to Lumbar Spine Anatomy 228 West Main St., Suite D Missoula, MT 59802-4345 Phone: 406-721-3072 Fax: 406-721-2619 info@eorthopod.com DISCLAIMER: The information in this booklet is compiled

More information

Unlisted Procedure Codes Frequently Asked Questions

Unlisted Procedure Codes Frequently Asked Questions Unlisted Procedure Codes Frequently Asked Questions Use of an unlisted code is common when a physician performs a new procedure or utilizes new technology when no other CPT code adequately describes the

More information

If you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time.

If you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time. If you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time. You may be worried about your future, both in respect of finances and

More information

ANTERIOR CERVICAL DISCECTOMY AND FUSION. Basic Anatomical Landmarks: Anterior Cervical Spine

ANTERIOR CERVICAL DISCECTOMY AND FUSION. Basic Anatomical Landmarks: Anterior Cervical Spine Anterior In the human anatomy, referring to the front surface of the body or position of one structure relative to another Cervical Relating to the neck, in the spine relating to the first seven vertebrae

More information

Patient Guide to Neck Surgery

Patient Guide to Neck Surgery The following is a sampling of products offered by Zimmer Spine for use in Anterior Cervical Fusion procedures. Patient Guide to Neck Surgery Anterior Cervical Fusion Trinica Select With the Trinica and

More information

Spine and Femoral Head Instrumentation for the Radiologist. Mariam S. Aboian, Gillian Lieberman MBBS

Spine and Femoral Head Instrumentation for the Radiologist. Mariam S. Aboian, Gillian Lieberman MBBS Spine and Femoral Head Instrumentation for the Radiologist Mariam S. Aboian, Gillian Lieberman MBBS Spine and Hip Instrumentation for the Radiologist Radiologists, Neurosurgeons, Orthopedic Surgeons =

More information

1 Operative Management of Common Spinal Conditions

1 Operative Management of Common Spinal Conditions 1 Operative Management of Common Spinal Conditions 2 Brett Menmuir Reno Orthopedic Clinic ROC Overview What was I thinking? Herniated Disc Stenosis Low Back Pain Neck Pain Sacroiliac Joint Dysfunction

More information

The Petrylaw Lawsuits Settlements and Injury Settlement Report

The Petrylaw Lawsuits Settlements and Injury Settlement Report The Petrylaw Lawsuits Settlements and Injury Settlement Report BACK INJURIES How Minnesota Juries Decide the Value of Pain and Suffering in Back Injury Cases The Petrylaw Lawsuits Settlements and Injury

More information

Award of Dispute Resolution Professional

Award of Dispute Resolution Professional In the Matter of the Arbitration between Neurosurgical Spine Specialists of NJ A/S/O D.O. CLAIMANT(s), Forthright File No: NJ1102001370534 Insurance Claim File No: 0336333740101035 Claimant Counsel: Law

More information