Appendix 1: Surgical CPT Codes
CPT4 Code
20930
20931
20936
20937
20938
22548
22558
22585
22612
22614
Description
Allograft for spine surgery only, morselized
Allograft for spine surgery only, structural
Autograft for spine surgery only, local
Autograft for spine surgery only, morselized
Autograft for spine surgery only, structural
Arthrodesis, anterior transoral or extraoral technique
Arthrodesis, anterior interbody technique, including minimal
discectomy, lumbar
Arthrodesis, anterior approach, lumbar, each additional interspace
22630
22632
Arthrodesis, posterior or posterolateral technique, lumbar
Arthrodesis, posterior or posterolateral technique, each additional
vertebral segment
Arthrodesis, posterior interbody technique, lumbar
Arthrodesis, posterior interbody technique, each additional interspace
22830
22840
22841
22842
22843
Exploration of spinal fusion
Posterior non-segmental instrumentation
Internal spinal fixation by wiring of spinous processes
Posterior segmental instrumentation, 3-6 vertebral segments
Posterior segmental instrumentation, 7-12 vertebral segments
22844
Posterior segmental instrumentation, 13+ vertebral segments
22845
22846
22847
22849
22850
22851
22852
22855
63005
Anterior instrumentation, 2-3 vertebral segments
Anterior instrumentation, 4-7 vertebral segments
Anterior instrumentation, 8+ vertebral segments
Reinsertion of spinal fixation device
Removal of posterior nonsegmental instrumentation
Application of intervertebral biomechanical device
Removal of posterior segmental instrumentation
Removal of anterior instrumentation
Laminectomy with exploration and/or decompression, 1-2 vertebral
segments, lumbar
Laminectomy with exploration and/or decompression, 1-2 vertebral
segments, sacral
Laminectomy with removal of abnormal facets .. with decompression,
lumbar
Laminectomy with exploration and/or decompression, >2 vetebral
segments, lumbar
Laminotomy (hemilaminectomy) with decompression, 1 interspace,
lumbar
Laminotomy (hemilaminectomy) with decompression, each additional
interspace, cervial or lumbar
63011
63012
63017
63030
63035
1
63042
63044
63047
63048
63056
63057
63170
63185
63190
63200
63267
63268
63272
63273
22224
22226
62287
69990
Laminotomy (hemilaminectomy) with decompression, reexploration, 1
interspace, lumbar
Laminotomy (hemilaminectomy) with decompression, reexploration,
each additional lumbar interspace
Laminectomy, facetectomy, and foraminotomy with decompression, 1
vertebral segment, lumbar
Laminectomy, facetectomy, and foraminotomy with decompression,
each additional vertebral segment
Transpedicular approach with decompression, 1 segment, lumbar
Transpedicular approach with decompression, each additional segment,
lumbar
Laminectomy with myelotomy, cervical, thoracic, or thoracolumbar
Laminectomy with rhizotomy, 1-2 segments
Laminectomy with rhizotomy, more than 2 segments
Laminectomy, with release of tethered spinal cord, lumbar
Laminectomy with excision or evacuation of intraspinal lesion other
than neoplasm, lumbar
Laminectomy with excision or evacuation of intraspinal lesion other
than neoplasm, sacral
Laminectomy for excision of intraspinal lasion other than neoplasm,
lumbar
Laminectomy for excision of intraspinal lasion other than neoplasm,
sacral
Osteotomy of spine, including didcectomy, lumbar
Osteotomy of spine, including didcectomy, each additional segment
Aspiration or decompression procedure, percutaneous, of nucleus
pulposus of intervertebral disc (e.g., percutaneous discectomy,
percutaneous laser discectomy)
Microsurgical techniques, requiring use of operating microscope
2
Appendix 2: Low Back Injury Severity Code Groups Based on ICD-9 Codes
ICD-9
Code
Description
More Severe
344.60
Syndrome, cauda equina NOS
344.61
Synd, cauda equina w/neuro bladder
353.1
Lesions, lumbosacral plexus
353.4
Lesions, lumbosacral root NEC
353.8
Disorder, nerve root/plexus NEC
353.9
Disorder, nerve root/plexus NOS
355.0
Lesion, sciatic nerve
721.42
Spondylosis, lumbar w/myelopathy
722
Disorders, intervertebral disc
722.1
Dsplcmnt thorc/lmbr disc w/o myelpy
722.10
Dsplcmnt, lumbar disc w/o myelpy
722.2
Displacement, disc NOS w/o myelpy
722.7
Dsord, intervertebral disc w/myelpy
722.70
Disorder, disc NOS w/myelopathy
722.73
Disorder, lumbar disc w/myelopathy
722.83
Syndrome, postlaminectomy, lumbar
724.0
Stenosis, spinal, oth than cervical
724.00
Stenosis, spinal, unspec region
724.02
Stenosis, spinal, lumbar
724.09
Stenosis, spinal, other spec site
724.3
Sciatica
724.4
Neuritis, lumbosacral NOS
724.6
Disorders, sacrum (incl. LS jt. instability)
729.2
Neuralgia/neuritis NOS
738.4
Spondylolisthesis, acquired
756.1
Anomaly, congenital, spine
756.10
Anomaly, congenital, spine NOS
756.11
Spondylolysis, cngn, lumbosacral
756.12
Spondylolisthesis, congenital
953.2
Injury, lumbar root
953.5
Injury lumbosacral plexus
956.0
Injury sciatic nerve
Less Severe
349.9
Disorder, nervous system NOS
720.0
Spondylitis, ankylosing
720.1
Enthesopathy, spinal
720.2
Sacroiliitis NEC
720.9
Spondylopathy, inflammatory NOS
721.3
Spondylosis, lumbosacral
721.7
Spondylopathy, traumatic
721.8
Disorder, spinal NEC
721.9
Spondylosis NOS
721.90
Spondylosis NOS w/o myelopathy
722.32
Schmorl's nodes, lumbar region
722.5
722.52
722.6
722.9
722.90
722.93
724
724.2
724.5
724.7
724.71
724.79
724.8
724.9
728.2
728.8
728.85
728.9
729.1
729.9
737.3
737.30
737.39
738.5
739.3
739.4
756.15
793.7
799.8
839.2
839.20
839.42
839.69
839.8
846
846.0
846.1
846.2
846.3
846.8
846.9
847
847.2
847.3
847.4
847.9
848.8
848.9
Dgnratn, thorc/lumbar disc
Degeneration, lumbar/lmbsac disc
Degeneration, disc NOS
Dsord, intrvrtbrl disc, oth & unspc
Disorder NEC/NOS, unspecified disc
Disorder NEC/NOS, lumbar disc
Disorders, back, other & unspc
Lumbago
Backache NOS
Disorders, coccyx
Hypermobility, coccyx
Disorder, coccyx NEC
Symptom, back NEC
Disorder, back NOS
Atrophy, muscular disuse NEC
Disorders, muscle/ligament/fascia
Spasm, muscle
Disorder, muscle/ligament NOS
Myalgia/myositis NOS
Disorder, soft tissue NEC/NOS
Kyphoscoliosis and scoliosis
Scoliosis, idiopathic
Scoliosis NEC
Deformity, acquired, back/spine NEC
Lesion, nonallopathic, lumbar rgn
Lesion, nonallopathic, sacral rgn
Fusion, spine, congenital
Nonspecif abnl radiolog fnd, musculoskl systm
Condition, ill-defined NEC
Dsloc, thoracic/lumbar vrt, clsd
Dsloc lumbar vertebra, closed
Dislocation sacrum, closed
Dislocation site NEC, closed
Dislocation, mlt/ill-defined, clsd
Sprain/strain, sacroiliac region
Sprain/strain, lumbosacral
Sprain/strain, sacroiliac ligament
Sprain/strain, sacrospinatus
Sprain/strain, sacrotuberous
Sprain/strain, sacroiliac site NEC
Sprain/strain, sacroiliac site NOS
Sprains/strain oth/unspc parts back
Sprain/strain, lumbar region
Sprain/strain, sacrum
Sprain/strain, coccyx
Sprain/strain, back NOS
Sprain/strain NEC
Sprain/strain NOS
3
905.7
922.3
922.31
922.32
922.9
959.1
959.19
Late effect, sprain/strain
Contusion, back
Contusion, back
Contusion, buttock
Contusion, trunk NOS
Injury NOS, trunk
Injury NOS, other sites trunk
4
5