APPENDIX Table 1: Description of Surgical Categories and Patient Selection

APPENDIX Table 1: Description of surgical categories and patient selection.

Include:

Any patient, from the Pediatric ACS NSQIPwho underwent a spinal fusion procedure with one of the following CPT codes:

22800 or 22842 - Poster Fusion and Instrumentation Up to 6 Levels
22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels
22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels
22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels
22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels
22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels

Exclude:

Patients with a wound class of 2 or 3, patients with an open wound on their body, patients with current sepsis, patients requiring blood pressure support pre-operatively, patients with current pneumonias, patient with prior surgeries within 30 days, patients in a coma at the time of surgery, or any patients undergoing a non-elective procedure.

Define a wound complication as any patient with a superficial surgical site infection, a deep surgical site infection, a wound dehiscence, or an organ space infection.

After defining the groups, separate into the following categories according to the type of procedure performed:

1. Isolated Primary Posterior Arthrodesis:

Patients who have at least one of the following CPT Codes in any coding position:

22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels
22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels
22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels

AND who do NOT have on of the following codes for revision procedures or Anterior Arthrodesis:

22852-removal of posterior segmental instrumentation
22850 - removal of posterior non-segmental instrumentation (e.g. harrington rod)
22855 - removal of anterior instrumentation
22849 - Reinsertion of spinal fixation device
22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels
22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels
22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels
2. Revision Posterior Arthrodesis:
Patients who have at least one of the following CPT Codes in any coding position:

22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels

22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels

22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels

AND who DOhave one of the following three codes for revision:

22852-removal of posterior segmental instrumentation
22850 - removal of posterior non-segmental instrumentation (e.g. harrington rod)
22855 - removal of anterior instrumentation

3. Isolated Primary Anterior Arthrodesis

Patients who have at least one of the following CPT Codes in any coding position:

22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels

22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels

22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels

AND who DO NOT have one of the following codes for revision procedures or for posterior arthrodesis:

22852-removal of posterior segmental instrumentation
22850 - removal of posterior non-segmental instrumentation (e.g. harrington rod)
22855 - removal of anterior instrumentation

22849 - Reinsertion of spinal fixaiton device

4. Revision Anterior Arthrodesis

Patients who have at least one of the following CPT Codes in any coding position:

22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels

22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels

22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels

AND who DO have one of the following codes for revision procedures:

22852-removal of posterior segmental instrumentation
22850 - removal of posterior non-segmental instrumentation (e.g. harrington rod)
22855 - removal of anterior instrumentation

4. Combined Anterior and Posterior Arthrodesis

Patients who have at least one of the following CPT Codes in any coding position:

AND who DO have at least one of the following Anterior Fusion Codes:

22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels

22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels

22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels

5. Patients With Bone Grafting:

Patients who have at least one of the following CPT Codes in any coding position:

22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels

22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels

22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels

22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels

22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels

22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels

AND Who DO have at least one of the following CPT Codes:

Autograft (20936, 20937, 20938)
Allograft (20930, 20931)
Bone Marrow Aspirate (38220)

6. Patients With Fusions to the Pelvis:

Patients who have at least one of the following CPT Codes in any coding position:

22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels

22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels

22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels

22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels

22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels

22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels

AND Who DO have at least one of the following CPT Codes:

22848 – pelvic fixation

7. Patients who underwent an osteotomy:

Patients who have at least one of the following CPT Codes in any coding position:

22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels

22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels

22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels

22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels

22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels

22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels

AND Who DO have at least one of the following CPT Codes for osteotomies:

22206, 22207, 22208, 22210, 22212, 22214, 22216, 22220, 22222, 22224, 22226

8. Patients Who Had an Intervertebral Device Inserted

Patients who have at least one of the following CPT Codes in any coding position:

22808 or 22845 - Anterior Fusion or Instrumentation 2-3 levels

22810 or 22846 - Anterior Fusion or Instrumentation 4-7 levels

22812 or 22847 - Anterior Fusion or Instrumentation 8 or more levels

22800 or 22842 - Poster Fusion and Instrumentation up to 6 Levels

22802 or 22843 - Posterior Fusion and Instrumentation 7-12 Levels

22804 or 22844- Posterior Fusion and Instrumentation 13 or more levels

AND Who DO have at least one of the following CPT Codes for intervertebral device insertion:

22851