CPT and ICD9-CM Algorithm
Appendices
Appendix 1: ICD9 CM Spine Surgery Procedure Codes
03.01 Removal of foreign body from spinal canal / 81.00 Spinal fusion, not otherwise specified03.02 Reopening of laminectomy site / 81.01 Atlas-axis spinal fusion
03.09 Other exploration and decompression of spinal canal / 81.02 Other cervical fusion, anterior technique
03.1 Division of intraspinal nerve root / 81.03 Other cervical fusion, posterior technique
03.29 Other chordotomy / 81.04 Dorsal and dorsolumbar fusion, anterior technique
03.4 Excision of destruction of lesion of spinal cord or spinal meninges / 81.05 Dorsal and dorsolumbar fusion, posterior technique
03.51 Repair spinal meningocele / 81.06 Lumbar and lumbosacral fusion, anterior technique
03.53 Repair of vertebral fracture / 81.07 Lumbar and lumbosacral fusion, lateral transverse process technique
03.59 Other repair and plastic operations on spinal cord structures / 81.08 Lumbar and lumbosacral fusion, posterior technique
03.6 Lysis of adhesions of spinal cord and nerve roots / 81.30 Refusion of spine, not otherwise specified
03.71 Spinal subarachnoid-peritoneal shunt / 81.31 Refusion of atlas-axis spine
03.79 Other shunt of spinal theca / 81.32 Refusion of other cervical spine, anterior technique
03.90 Insertion of catheter into spinal canal for infusion of therapeutic or palliative substances / 81.33 Refusion of other cervical spine, posterior technique
03.92 Injection of other agent into spinal canal / 81.34 Refusion of dorsal and dorsolumbar spine, anterior technique
03.93 Implantation or replacement of spinal neurostimulator lead / 81.35 Refusion of dorsal and dorsolumbar spine, posterior technique
03.94 Removal of spinal neurostimulator lead(s) / 81.36 Refusion of lumbar and lumbosacral spine, anterior technique
03.97 Revision of spinal thecal shunt / 81.37 Refusion of lumbar and lumbosacral spine, lateral transverse process technique
03.98 Removal of spinal thecal shunt / 81.38 Refusion of lumbar and lumbosacral spine, posterior technique
03.99 Other operations on spinal cord and spinal canal structures, other / 81.39 Refusion of spine, NEC
77.69 Local excision of lesion or tissue of bone, other / 81.62 Fusion or refusion of 2-3 vertebrae
77.79 Excision of bone for graft, other / 81.63 Fusion or refusion of 4-8 vertebrae
78.49 Other repair or plastic operations on bone, other; other operation on bone NEC, repair of malunion or nonunion fracture NEC / 81.64 Fusion or refusion of 9 or more vertebrae
78.59 Internal fixation of bone without fracture reduction; internal fixation of bone (prophylactic), reinsertion of internal fixation device, revision of displaced or broken fixation device, other / 81.65 Vertebroplasty
81.66 Kyphoplasty
78.69 Removal of implanted devices from bone; external fixator device (invasive), internal fixation device, removal of bone growth stimulator (invasive), removal of internal limb lengthening device, other / 84.51 Insertion of interbody spinal fusion device
80.50 Excision or destruction of intervertebral disc, unspecified / 84.52 Insertion of recombinant bone morphogenetic protein
80.51 Excision of intervertebral disc
Appendix 2: Cervical Spine-Specific ICD9-CM Procedure and Diagnosis Codes
ICD-9Procedure Code / Description: Cervical-specific
Anterior Fusion
81.02 / Other cervical fusion, anterior technique
81.32 / Refusion of other cervical spine, anterior technique (arthrodesis of C2 level or below)
Posterior Fusion
81.03 / Other cervical fusion, posterior technique
81.33 / Refusion of other cervical spine, posterior technique (arthrodesis of C2 level or below)
ICD-9
Diagnosis Code / Description: Cervical-specific
Herniated Disc
722.0 / Displacement of cervical disc without myelopathy
Spondylosis
721.0 / Cervical spondylosis without myelopathy
722.4 / Degeneration of cervical intervertebral disc
Myelopathy
721.1 / Cervical spondylosis with myelopathy
722.71 / Intervertebral disc disorder with myelopathy, cervical
Radiculopathy
723.4 / Brachial neuritis or radiculitis NOS, cervical radiculitis or radicular syndrome of the upper limbs
Spinal Stenosis
723.0 / Spinal stenosis in cervical region
Other
722.81 / Postlaminectomy syndrome, cervical
723.1 / Cervicalgia
723.7 / Ossification of the posterior longitudinal ligament in cervical region
738.2 / Acquired deformity of neck
Appendix 3: Definite Cervical Spine CPT Codes, Degenerative
22554, +22585 / Arthrodesis, anterior, including minimal discectomy to prepare interspace, cervical below C222600, +22614 / Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment; add-on level code
63001 / Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy, or discectomy, (eg, spinal stenosis), 1-2 vertebral segments, cervical
63015 / Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy, or discectomy, (eg, spinal stenosis), more than 2 vertebral segments, cervical
63020, +63035 / Laminotomy (hemilaminectomy) with decompression of nerve root(s) including partial facetectomy, foraminotomy, and/or excision of herniated intervertebral disk; one interspace, cervical; -50 for bilateral, add-on for 63020, each additional interspace, cervical or lumbar
63040, +63043 / Reexploration laminotomy (hemilaminectomy) with decompression of nerve root(s) including partial facetectomy, foraminotomy, and/or excision of herniated intervertebral disk, reexploration, single interspace, cervical; -50 for bilateral, add-on for 63020, each additional interspace, cervical
63045, +63048 / Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root(s), (eg, spinal or lateral recess stenosis), single vertebral segment, cervical; add-on is NS
63050 / Laminoplasty, cervical, with decompression of the spinal cord, 2+ segments 2005 code
63051 / Laminoplasty, cervical, with reconstruction of the posterior bony elements (bridging bone graft, wire, suture, miniplates, etc.)
63075, +63076 / Diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace; add-on for additional cervical discectomy decompression
63081, +63082 / Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment; add-on for cervical, each additional segment
Appendix 4: Spine Specific (not cervical specific) CPT spine codes
22830 / Exploration of spinal fusion22840 / Posterior nonsegmental instrumentation, pedicle fixation across one interspace, Harrington rods, sublaminar wiring at C1, atlantoaxial transarticular screw, facet screw fixation
22841 / Internal spinal fixation by wiring of spinous process
22842, 22843, 22844 / Posterior segmental instrumentation 3-6 segments, 7-12 segments, 13+ segments
22845, 22846, 22847 / Anterior instrumentation, 2-3, 4-7, 8+ vertebral segments
22849 / Reinsertion of spinal fixation device
22850 / Removal of posterior nonsegmental instrumentation (eg, Harrington rod)
22851 / Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), threaded bone dowel(s), methylmethacrylate) to vertebral defect or interspace (List separately in addition to code for primary procedure)
22852 / Removal of posterior segmental instrumentation
22855 / Removal of anterior instrumentation
22899 / Unlisted procedure, spine (NS)