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

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

2 cervical area thoracic area lumbar area sacrum coccyx Mayfield Clinic 2

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6 Zoran Maric, MD Spine Surgery Procedures How to Document and Code Effectively Zoran Maric, MD Figure 12.1 Skin incision for microscopic laminotomy and discectomy. Spine Surgery Procedures How to Document and Code Effectively Zoran Maric, MD 6

7 Spine Surgery Procedures How to Document and Code Effectively Zoran Maric, MD 7

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11 Spine Surgery Procedures How to Document and Code Effectively Zoran Maric, MD Spine Surgery Procedures How to Document and Code Effectively Zoran Maric, MD 11

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13 Spine Surgery Procedures How to Document and Code Effectively Zoran Maric, MD 13

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15 Spine Surgery Procedures How to Document and Code Effectively Zoran Maric, MD 15

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17 Spine Surgery Procedures How to Document and Code Effectively Zoran Maric, MD Spine Surgery Procedures How to Document and Code Effectively Zoran Maric, MD 17

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21 Repairing Spine Fractures STEP 1 Through a half inch incision, small instruments are placed into the fractured vertebral body to create a working channel. Repairing Spine Fractures STEP 2 The KyphX Inflatable Bone Tamp (IBT) is then placed into the fracture. 5/5/09 21

22 Repairing Spine Fractures STEP 3 The device is carefully inflated, creating a cavity inside the vertebral body. Repairing Spine Fractures STEP 4 The cavity is filled with bone cement to stabilize the fracture. Once filled, the incision is closed. 22

23 MMG

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25 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 25

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27 Lumbar [Arthrodesis] (with or without lateral transverse technique) Each additional vertebral segment (List separately in addition to code for primary procedure) Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure) 27

28 Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), threaded bone dowel(s), methylmethacrylate) to vertebral defect or interspace 28

29 Morselized (through separate skin or fascial incision) (List separately in addition to code for primary procedure) 29

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31 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, including open and endoscopically assisted approaches; 1 interspace, lumbar 31

32 Thank you for coming! 32