AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Issue 1; Ask the Editor

Staged Scoliosis Surgery with Iliac Fixation and Spinal Fusion

A 52-year-old female, who is diagnosed with adult thoracolumbar scoliosis, underwent a staged anterior thoracolumbar fusion of T12-S1 one day ago. The patient is now being returned to the operative suite for stage II of the procedure which involves bilateral iliac fixation and posterior instrumented T10-S1 fusion with the VIPER® 2 System and bone graft. At surgery, screws were placed and recessed inside the iliac crest where bone had been excised for use as bone graft. Next, pedicle screws were inserted from T10-S1 followed by preparation of titanium rods preloaded with iliac connectors. The titanium rods with iliac connector were placed into the iliac screw. Derotation was performed from T12 down to S1 achieving spinal alignment. Finally, bone graft was placed in the posterior-lateral gutter for the posterolateral fusion. Is it appropriate to assign a separate code for bilateral iliac fixation performed with spinal fusion? ...

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