Spinal fusion guidelines for ICD-10-PCS
ICD-10-PCS includes specific guidelines for coding spinal fusion procedures, including guidelines for selecting the body part value.
The body part for a spinal vertebral joint(s) rendered immobile by a spinal fusion procedure is classified by the level of the spine (e.g. thoracic).
ICD-10-PCS includes distinct body part values for a single vertebral joint and for multiple vertebral joints at each spinal level.
Body part values specify:
- Lumbar vertebral joint
- Lumbar vertebral joints, 2 or more
- Lumbosacral vertebral joint
If the physician fuses multiple vertebral joints, report a separate code for each vertebral joint that uses a different device and/or qualifier.
For example: For a fusion of lumbar vertebral joint, posterior approach, anterior column and fusion of lumbar vertebral joint, posterior approach, posterior column, coders would report two codes.
About the Author: Michelle A. Leppert, CPC, is a senior managing editor specializing in outpatient coding for JustCoding.com, which provides coders, coding supervisors, and health information management (HIM) directors with educational resources to test their coding knowledge, employ correct coding guidelines, and stay abreast of CMS transmittals. 
Stephanie | Mar 6, 2013 | Reply
A specific code is available for the thoracolumbar vertebral joint 0RGA***. Does this solely represent T12 -L1? Would an additional code be assigned if T10-12 are fused as well? What code would you assign?