AHA Coding Clinic® for ICD-9 - 1999 Fourth Quarter

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Our orthopedist stated that a spinal fusion performed for repair of a vertebral fracture involves removal of bone fragments from the fracture site and realignment of the vertebra. Since the repair of a traumatic vertebral fracture is more extensive than an elective spinal fusion (code 81.0x), he feels that code 03.53, Repair of vertebral fracture, should be assigned along with a code from category 81.0, Spinal fusion. What are the appropriate code assignments when vertebral fracture repair is performed by spinal fusion? For example, this 19-year-old patient was involved in a motor vehicle accident and suffered an L1 rotation burst fracture dislocation with incomplete conus medullaris injury. A posterior spinal fusion with Synthes instrumentation, T11-L2, right iliac crest bone graft, anterior L1 corpectomy, T12-L2, and left iliac crest strut graft via retroperitoneal approach were performed. How should these procedures be coded? ...

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