CERVICAL PROCEDURES PHYSICIAN CODING Anterior Cervical Discectomy with Interbody Fusion (ACDF) Anterior interbody fusion, with discectomy and decompression; cervical below C2 22551 first interspace 22552 each additional interspace Anterior Instrumentation 22845 2 3 vertebral segments 22846 4 7 vertebral segment 22847 8 or more vertebral segments Note: Do not report 22554 or 22585 with 63075 or 63076 even if performed by different physicians. To report anterior cervical discectomy and interbody fusion at the same level during the same session, use 22551. Cervical Arthroplasty Total Disc Arthroplasty, Anterior Approach, Cervical 22856 single interspace Laminoplasty Laminoplasty, Cervical 63050 two or more vertebral segments With Reconstruction 63051 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 866-946-0444.
CERVICAL PROCEDURES FACILITY CODING Anterior Cervical Discectomy with Interbody Fusion (ACDF) with Anterior Plate Anterior column fusion, anterior approach, cervical 81.02 (C2 level or below) Discectomy 80.51 Insertion of interbody spinal fusion device 84.51 Fusion or refusion of 2-3 vertebrae (or) 81.62 Fusion or refusion of 4-8 vertebrae 81.63 Excision of bone for graft, other 77.79 harvested from the iliac crest or locally Intra-operative monitoring 00.94 Note: Instrumentation is included in the fusion code and not reported separately. If structural allograft is used, do not report code 84.51. Allograft is included in the fusion code and not separately reported. Cervical Arthroplasty Cervical arthroplasty 84.62 Laminoplasty Other exploration and decompression of spinal 03.09 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 866-946-0444. Page 2 of 15
LUMBAR PROCEDURES PHYSICIAN CODING Anterior Lumbar Interbody Fusion (ALIF) with Posterior Instrumentation Anterior Interbody Fusion, Lumbar 22558 first interspace 22585 each additional interspace Application of Biomechanical Device (cages, etc.) 22851 first interspace, if applicable 22851 59 each additional interspace Posterior Instrumentation 22840 non-segmental instrumentation 22842 segmental; 3 6 vertebral segments 22843 segmental; 7 12 vertebral segments 22844 segmental; 13+ vertebral segments ALIF with Anterior Instrumentation Anterior Interbody Fusion, Lumbar 22558 first interspace 22585 each additional interspace Application of Biomechanical Device (cages, etc.) 22851 first interspace, if applicable 22851 59 each additional interspace Anterior Instrumentation 22845 2 3 vertebral segments 22846 4 7 vertebral segments 22847 8 or more vertebral segments Page 3 of 15
ALIF and Posterolateral Fusion (Classic 360 Procedure) Posterolateral Fusion, Lumbar 22612 first level 22614 each additional segment Anterior Interbody Fusion, Lumbar 22558 51 first interspace 22585 each additional interspace Posterior Instrumentation 22840 non-segmental instrumentation 22842 segmental; 3 6 vertebral segments 22843 segmental; 7 12 vertebral segments 22844 segmental; 13+ vertebral segments Application of Biomechanical Device (cages, etc.) 22851 for first interspace, if applicable 22851 59 each additional interspace Posterior Lumbar Interbody Fusion (PLIF) or Transforaminal Lumbar Interbody Fusion (TLIF) with Posterior Instrumentation Posterior Interbody Fusion, Lumbar 22630 first interspace 22632 each additional interspace Application of Biomechanical Device (cages, etc.) 22851 first interspace, if applicable 22851 59 each additional interspace Posterior Instrumentation 22840 non-segmental instrumentation 22842 segmental; 3 6 vertebral segments 22843 segmental; 7 12 vertebral segments 22844 segmental; 13+ vertebral segments Note: Codes 63030 and 63047 are bundled per the NCCI edits with code 22630. 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
Laminectomy, Lumbar Laminectomy without facetectomy, foraminotomy or 63005 one or two vertebral segments discectomy,lumbar, except for spondylolisthesis 63017 more than 2 vertebral segments Laminectomy with removal of abnormal facets and/or 63012 Gill-type procedure pars interarticularis with decompression, for spondylolisthesis, lumbar Laminotomy (hemilaminectomy), including partial 63030 one interspace facetectomy, foraminotomy and/or excision of herniated disc, lumbar 63035 each additional interspace Laminotomy (hemilaminectomy), including partial 63042 one interspace facetectomy, foraminotomy and/or excision of herniated disc, re-exploration, lumbar 63044 each additional interspace Laminectomy, facetectomy and foraminotomy, lumbar 63047 single vertebral segment 63048 each additional segment PLIF/TLIF and Posterolateral Fusion (Single Incision 360 ) Combined fusion, posterolateral fusion, with posterior 22633 first interspace and segment interbody fusion 22634 each additional interspace/segment Posterior Instrumentation 22840 non-segmental instrumentation 22842 segmental; 3 6 vertebral segments 22843 segmental; 7 12 vertebral segments 22844 segmental; 13+ vertebral segments Application of Biomechanical Device (cages, etc.) 22851 first interspace, if applicable 22851 59 each additional interspace Note: Codes 63030 and 63047 are bundled per the NCCI edits with code 22630. 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
Direct Lateral Fusion with Anterior Instrumentation (DLIF) Anterior Interbody Fusion, Lumbar 22558 first interspace 22585 each additional interspace Application of Biomechanical Device (cages, etc.) 22851 first interspace, if applicable 22851 59 each additional interspace Anterior Instrumentation 22845 2 3 vertebral segments 22846 4 7 vertebral segments 22847 8 or more vertebral segments Posterolateral Fusion with Posterior Instrumentation Posterolateral Fusion, Lumbar 22612 first level 22614 each additional segment Posterior Instrumentation 22840 non-segmental instrumentation 22842 segmental; 3 6 vertebral segments 22843 segmental; 7 12 vertebral segments 22844 segmental; 13+ vertebral segments Percutaneous Vertebroplasty Percutaneous vertebroplasty, one vertebral body, 22520 thoracic unilateral, or bilateral injection 22521 lumbar 22522 each additional level Note: Imaging guidance is reported separately when performed. Report code 72291-26 for fluoroscopic guidance or 72292-26 for CT guidance. Page 6 of 15
Percutaneous Vertebral Augmentation Percutaneous vertebral augmentation, including cavity 22523 thoracic creation (fracture reduction and bone biopsy included when performed) using mechanical device, one vertebral body, unilateral or bilateral cannulation (e.g., kyphoplasty) 22524 lumbar 22525 each additional level Note: Imaging guidance is reported separately when performed. Report code 72291-26 for fluoroscopic guidance or 72292-26 for CT guidance. Discectomy, Lumbar Posterior Discectomy, Lumbar 63030 first interspace 63035 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 866-946-0444. Page 7 of 15
LUMBAR PROCEDURES FACILITY CODING Anterior Lumbar Interbody Fusion (ALIF) with Instrumentation Anterior column fusion, anterior approach, lumbar 81.06 anterior interbody fusion Fusion or refusion of 2-3 vertebrae (or) 81.62 Fusion or refusion of 4-8 vertebrae (or) 81.63 Fusion or refusion of 9 or more vertebrae 81.64 Discectomy 80.51 Insertion of interbody spinal fusion device 84.51 Excision of bone for graft, other 77.79 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 84.51. 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 81.08 posterior interbody fusion Fusion or refusion of 2-3 vertebrae (or) 81.62 Fusion or refusion of 4-8 vertebrae (or) 81.63 Fusion or refusion of 9 or more vertebrae 81.64 Discectomy 80.51 Insertion of interbody spinal fusion device 84.51 Excision of bone for graft, other 77.79 harvested from the iliac crest or locally Intra-operative monitoring 00.94 Note: Instrumentation is included in the fusion code and not reported separately. If structural allograft is used, do not report code 84.51. Allograft is included in the fusion code and not separately reported. Posterolateral Fusion with Posterior Instrumentation Posterior column fusion, posterior approach, lumbar 81.07 posterolateral fusion Fusion or refusion of 2-3 vertebrae (or) 81.62 Fusion or refusion of 4-8 vertebrae (or) 81.63 Fusion or refusion of 9 or more vertebrae 81.64 Excision of bone for graft, other 77.79 harvested from the iliac crest or locally Intra-operative monitoring 00.94 Note: Instrumentation is included in the fusion code and not reported separately. Page 8 of 15
ALIF and Posterolateral Fusion with Instrumentation (Classic 360 Procedure) Anterior column fusion, anterior approach, lumbar 81.06 anterior interbody fusion Posterior column fusion, posterior approach, lumbar 81.07 posterolateral fusion Fusion or refusion of 2-3 vertebrae (or) 81.62 Fusion or refusion of 4-8 vertebrae (or) 81.63 Fusion or refusion of 9 or more vertebrae 81.64 Discectomy 80.51 Insertion of interbody spinal fusion device 84.51 Excision of bone for graft, other 77.79 harvested from the iliac crest or locally Intra-operative monitoring 00.94 Note: Instrumentation is included in the fusion code and not reported separately. If structural allograft is used, do not report code 84.51. 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 81.08 posterior interbody fusion Posterior column fusion, posterior approach, lumbar 81.07 posterolateral fusion Fusion or refusion of 2-3 vertebrae (or) 81.62 Fusion or refusion of 4-8 vertebrae (or) 81.63 Fusion or refusion of 9 or more vertebrae 81.64 Discectomy 80.51 Insertion of interbody spinal fusion device 84.51 Excision of bone for graft, other 77.79 harvested from the iliac crest or locally Intra-operative monitoring 00.94 Note: Instrumentation is included in the fusion code and not reported separately. If structural allograft is used, do not report code 84.51. Allograft is included in the fusion code and not separately reported. Direct Lateral Interbody Fusion (DLIF) Anterior column fusion, anterior approach, lumbar 81.06 anterior interbody fusion Fusion or refusion of 2-3 vertebrae (or) 81.62 Fusion or refusion of 4-8 vertebrae (or) 81.63 Fusion or refusion of 9 or more vertebrae 81.64 Discectomy 80.51 Insertion of interbody spinal fusion device 84.51 Excision of bone for graft, other 77.79 harvested from the iliac crest or locally Intra-operative monitoring 00.94 Note: If structural allograft is used, do not report code 84.51. Allograft is included in the fusion code and not separately reported. Page 9 of 15
Laminectomy Other exploration and decompression of spinal canal 03.09 Percutaneous Vertebroplasty Percutaneous verebroplasty 81.65 Percutaneous Vertebral Augmentation Percutaneous vertebral augmentation 81.66 Discectomy Discectomy 80.51 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 866-946-0444. Page 10 of 15
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: 81.02 Fusion, anterior column, other cervical, anterior technique 81.04 Fusion, anterior column, dorsal/dorsolumbar, anterior technique 81.06 Fusion, anterior column, lumbar/lumbosacral, anterior technique AND One or more of the following procedures: 81.03 Fusion, posterior column, other cervical, posterior technique 81.05 Fusion, posterior column, dorsal/dorsolumbar, posterior technique 81.07 Fusion, posterior column, lumbar/lumbosacral, posterior technique 81.08 Fusion, anterior column, lumbar/lumbosacral, posterior technique Spinal Refusions One or more of the following procedures: 81.32 Refusion, anterior column, other cervical, anterior technique 81.34 Refusion, anterior column, dorsal/dorsolumbar, anterior technique 81.36 Refusion, anterior column, lumbar/lumbosacral, anterior technique AND One or more of the following procedures: 81.33 Refusion, posterior column, other cervical, posterior technique 81.35 Refusion, posterior column, dorsal/dorsolumbar, posterior technique 81.37 Refusion, posterior column, lumbar/lumbosacral, posterior technique 81.38 Refusion, anterior column, lumbar/lumbosacral, posterior technique Page 11 of 15
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: 015.02 Tuberculosis of bones and joints, vertebral column, bacteriological or histological examination unknown (at present) 015.04 Tuberculosis of bones and joints, vertebral column, tubercle bacilli not found (In sputum) by microscopy, but found by bacterial culture 015.05 Tuberculosis of bones and joints, vertebral column, tubercle bacilli not found by bacteriological examination, but tuberculosis confirmed histologically 170.2 Malignant neoplasm of vertebral column, excluding sacrum and coccyx 198.5 Secondary malignant neoplasm of bone and bone marrow 213.2 Benign neoplasm of bone and articular cartilage; vertebral column, excluding sacrum and coccyx 238.0 Neoplasm of uncertain behavior of other and unspecified sites and tissues; Bone and articular cartilage 239.2 Neoplasms of unspecified nature; bone, soft tissue, and skin 730.08 Acute osteomyelitis of other specified sites 730.18 Chronic osteomyelitis of other specified sites 730.28 Unspecified osteomyelitis of other specified sites 732.0 Juvenile osteochondrosis of spine 733.13 Pathologic fracture of vertebrae 737.0 Adolescent postural kyphosis 737.10 Kyphosis (acquired) (postural) 737.11 Kyphosis due to radiation 737.12 Kyphosis, postlaminectomy 737.19 Kyphosis (acquired), other 737.20 Lordosis (acquired) (postural) 737.21 Lordosis, postlaminectomy 737.22 Other postsurgical lordosis 737.29 Lordosis (acquired), other 737.30 Scoliosis [and kyphoscoliosis], idiopathic 737.31 Resolving infantile idiopathic scoliosis 737.32 Progressive infantile idiopathic scoliosis 737.33 Scoliosis due to radiation 737.34 Thoracogenic scoliosis 737.39 Other kyphoscoliosis and scoliosis 737.8 Other curvatures of spine 737.9 Unspecified curvature of spine 754.2 Congenital scoliosis 756.51 Osteogenesis imperfect The secondary diagnoses that will lead to DRG 456, 457 or 458 assignment are: 737.40 Curvature of spine, unspecified 737.41 Curvature of spine associated with other conditions, kyphosis 737.42 Curvature of spine associated with other conditions, lordosis 737.43 Curvature of spine associated with other conditions, scoliosis Page 12 of 15
Procedure code: 81.64 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: 81.00 Fusion, spinal NOS 81.04 Fusion, anterior column, dorsal/dorsolumbar, anterior technique 81.05 Fusion, posterior column, dorsal/dorsolumbar, posterior technique 81.06 Fusion, anterior column, lumbar/lumbosacral, anterior technique 81.07 Fusion, posterior column, lumbar/lumbosacral, posterior technique 81.08 Fusion, anterior column, lumbar/lumbosacral, posterior technique Spinal Refusions Include any of the following procedure codes: 81.30 Refusion, spinal NOS 81.34 Refusion, anterior column, dorsal/dorsolumbar, anterior technique 81.35 Refusion, posterior column, dorsal/dorsolumbar, posterior technique 81.36 Refusion, anterior column, lumbar/lumbosacral, anterior technique 81.37 Refusion, posterior column, lumbar/lumbosacral, posterior technique 81.38 Refusion, anterior column, lumbar/lumbosacral, posterior technique 81.39 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: 81.01 Fusion, atlas-axis 81.02 Fusion, anterior column, other cervical, anterior technique 81.03 Fusion, posterior column, other cervical, posterior technique Spinal Refusions Include any of the following procedure codes: 81.31 Refusion, atlas-axis 81.32 Refusion, anterior column, other cervical, anterior technique 81.33 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) 78.49 Other repair or plastic operations on bone 81.65 Percutaneous vertebroplasty 81.66 Percutaneous vertebral augmentation Page 13 of 15
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: 84.59 Insertion of other spinal devices 84.62 Insertion of total spinal disc prosthesis, cervical 84.65 Insertion of total spinal disc prosthesis, lumbosacral 84.80 Insertion or replacement of interspinous process device(s) 84.82 Insertion or replacement of pedicle-based dynamic stabilization device(s) 84.84 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: 03.02 Reopening, laminectomy site 03.09 Exploration and decompression, other spinal canal 03.1 Division, intraspinal nerve root 03.32 Biopsy, spinal cord or spinal meninges 03.39 Procedure, diagnostic other spinal cord and spinal cord structures 03.4 Excision or destruction, lesion, spinal cord or spinal meninges 03.53 Repair, vertebral fracture 03.59 Repair and plastic operation, other spinal cord structures 03.6 Lysis, adhesions, spinal cord and nerve root 03.93 Insertion or replacement, spinal neurostimulator 03.94 Removal, spinal neurostimulator 03.97 Revision, spinal thecal shunt 03.98 Removal, spinal thecal shunt 03.99 Operation, other, spinal cord and spinal canal structures 80.50 Excision or destruction, intervertebral disc, unspecified 80.51 Excision, intervertebral disc 80.53 Repair of the annulus fibrosus with graft or prosthesis 80.54 Other and unspecified repair of the annulus fibrosus 80.59 Destruction, other intervertebral disc 84.60 Insertion of spinal disc prosthesis, not otherwise specified 84.61 Insertion of partial spinal disc prosthesis, cervical 84.63 Insertion of spinal disc prosthesis, thoracic 84.64 Insertion of partial spinal disc prosthesis, lumbosacral 84.66 Revision or replacement of artificial spinal disc prosthesis, cervical 84.67 Revision or replacement of artificial spinal disc prosthesis, thoracic 84.68 Revision or replacement of artificial spinal disc prosthesis, lumbosacral 84.69 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 81.65 Percutaneous vertebroplasty 81.66 Percutaneous vertebral augmentation 84.81 Revision of interspinous process device(s) 84.83 Revision of pedicle-based dynamic stabilization device(s) 84.85 Revision of facet replacement device(s) Page 14 of 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 03.32 Biopsy, spinal cord or spinal meninges 03.39 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 03.99 Operation, other spinal cord and spinal canal structures 80.50 Excision or destruction, intervertebral disc, unspecified 80.51 Excision, intervertebral disc 80.53 Repair of the annulus fibrosus with graft or prosthesis 80.54 Other and unspecified repair of the annulus fibrosus 80.59 Destruction, other, intervertebral disc 81.0x Fusion, spinal 81.3x Revision, spinal 84.59 Insertion of other spinal devices 84.60 Insertion of spinal disc prosthesis, not otherwise specified 84.61 Insertion of partial spinal disc prosthesis, cervical 84.62 Insertion of total spinal disc prosthesis, cervical 84.63 Insertion of spinal disc prosthesis, thoracic 84.64 Insertion of partial spinal disc prosthesis, lumbosacral 84.65 Insertion of total spinal disc prosthesis, lumbosacral 84.66 Revision or replacement of artificial spinal disc prosthesis, cervical 84.67 Revision or replacement of artificial spinal disc prosthesis, thoracic 84.68 Revision or replacement of artificial spinal disc prosthesis, lumbosacral 84.69 Revision or replacement of artificial spinal disc prosthesis, not otherwise specified 84.80 Implantation of interspinous process decompression device(s) 84.82 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 866-946-0444. Page 15 of 15