A patient diagnosed with stenosis and degenerative spondylolisthesis underwent a 360-degree fusion. The provider documented Crescent PEEK interbody device, locally harvested autograft bone, some allograft bone, and bone morphogenic protein (BMP) were inserted into the disk space and maneuvered into the anterior third of the disk space. The space was packed primarily with autograft. Transfacet lumbar interbody fusion was completed. Pedicle screws were placed on the left using image guidance. Left transverse process fusion L4-L5 was performed with placement of harvested autograft bone and allograft morselized chips were supplemented posteriorly. Attention was directed to the anterior side using C-arm image intensifier to assist with confirming the position on the right. An incision was made to midline on the right and carried down to the fascia. PAK needle with image guidance penetrated the pedicle and body of L4. The same process was done at L5. Sextant rod was rotated in position, torqued, then released and removed. Sextant screws and Pedicle screws were in excellent position bilaterally. What is/are the correct code(s) for the fusion portion of the 360-degree fusion?
Assign the following ICD-10-PCS codes:
0SG0071, Fusion of lumbar vertebral joint with autologous tissue substitute, posterior approach, posterior column, open approach
0SG00AJ, Fusion of lumbar vertebral joint with interbody fusion device, posterior approach, anterior column, open approach
In this case, two codes are required because the 360-degree fusion involves both a posterior column and an anterior column fusion and there are two different qualifiers to represent the procedure performed. Additionally, the fusion involved a bone graft, utilizing locally harvested autograft bone, some allogaft, and BMP. The ICD-10-PCS Official Guidelines for Coding and Reporting state, “If a mixture of autologous and nonautologous bone graft (with or without biological or synthetic extenders or binders) is used to render the joint immobile, code the procedure with the device value Autologous Tissue Substitute.”