Coding for lumbar spinal fusion procedures in ASCs or outpatient centers is much different than coding for spinal fusion in the inpatient setting, according to the American Academy of Professional Coders.
Three differences to know:
1. The outpatient setting uses CPT codes, whereas the inpatient setting uses ICD-10-PCS.
2. CPT divides the spine into three sections: anterior, middle and posterior. ICD-10-PCS divides the spine into anterior and posterior.
3. CPT and ICD-10-PCS have differing code structures. One five-digit CPT code can capture several portions of a complex surgical procedure, but each character in ICD-10-PCS codes capture specific elements of a procedure.
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